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Title: The severe complications of radiation in patients treated with radiotherapy for cancer of the cervix and their impact on anorectal functions

Abstract:

Introduction. Cervical cancer is still a major problem worldwide epidemiological. In cervical cancer, surgical methods are used, radiotherapy, chemotherapy. To theside effects of radiotherapy include radiation reactions and their incidence and severity depends on many factors. A major factor deteriorating the quality of life of patients are rectovaginal fistula (RVF). In the literature, the global incidence ofradiation-induced RVF fistula is estimated at 0.3 - 6% Aim of the study. The aim of this study was to analyze the influence of radiotherapy used in the treatment of cervical cancer, the function of the lower gastrointestinal tract, urinary and genital tract, with particular emphasis on the impact of the functions of the anal sphincter complex, rated in anorectal manometry. Materials and methods. The study group enrolled 21 patients with carcinoma of the cervix and therefore radiotherapy. In each of the patients revealed the presence of radiation-induced RVF. The control group consisted of 19 patients with rectal cancer and therefore treated with radiotherapy. In all patients treated and control groups underwent gynecological and proctological examination and anorectal manometry. Survey was then carried out using standardized forms and scales assessing such severity of symptoms of fecal incontinence by Jorge-Wexner, the severity of early and late signs of radiation by EORTC/RTOG, Dische and LENT SOMA scale. Results. The anorectal manometry in the study group mean values were significantly lower than in the control group respectively for MRP (33.5 ± 12.6 vs. 45.1 ± 18.4, p= 0.025) and for SMEs (65.7 ± 22.6 vs. 108.3 ± 50.0, p = 0.008). The presence of rectovaginal fistula was connected instead of the more than 13 - fold (13x), astatistically significant increased risk of abnormal values MSP (p = 0.002). It was found that in the test group, both the mean and median values and the observed values of maximum scale Dische'a were significantly higher than in controls (17.8vs. 8.5, p <0.001). In the study group compared with the control group were almost 3- fold higher in Lent Score subjective assessment (1.5 vs 0.6, p <0.001), objective medical assessment (2.1 vs 0.8, p < 0.001) and treatment (1.1 vs. 0.4, p <0.001), and the values for the entire Lent Score scale (1.6 vs. 0.6, p <0.001). Conclusions. As a result of the study in patients with RVF after radiotherapy for cancer of the cervix was found a high incidence of abnormal anorectal manometry. Analysis of radiation-induced reactions in patients with RVF revealed a significant correlation between severity and scale of the evaluation results in the EORTC/RTOG, Dische'a and LENT SOMA (in both TOTAL SCORE and LENTSCORE) with a higher incidence in this group manometric abnormalities and with a lower incidence of full continence.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree discipline:

onkologia ; ginekologia

Degree grantor:

Uniwersytet Jagielloński. Collegium Medicum. Wydział Lekarski.

Promoter:

Roman M. Herman

Date issued:

2012

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:3597

Call number:

ZB-118580

ControlNumberVIRTUA:

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Language:

pol

Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

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Last modified:

Jul 18, 2019

In our library since:

Jul 18, 2013

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13

Number of object content views in PDF format

13

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/3597

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ZB-118580 Jul 18, 2019
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