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Toxic effects of Radiotherapy for Female Patients over 60 Years of Age with Gynecological Tumors
POLODNOVÁ, Šárka
Cervical cancer and cancer within the body of the uterus are the most frequent cancers of the female reproductive organs, the incidence of which is on the rise. Every year, more than 1,000 new cases of cervical cancer are diagnosed in the Czech Republic, as well as 1,500 cases of endometrial cancer. Surgical treatment and external radiotherapy are used during therapy and, in some cases, it is combined with brachytherapy and chemotherapy. I focused on the early toxicity of radiotherapy, which can be a limiting factor for the completion of treatment, especially in older patients. The investigated sample consists of 100 female patients who were divided into 4 groups, according to age and the primary diagnosis of these patients. Each group consists of 25 women. Patients in the first group are represented in a group of those under 60 years of age with cervical cancer; the average age is 48 years. The second group consists of patients with the same diagnosis, but who are over 60 years of age; the average age is 66 years. The third group consists of patients who are under 60 years of age who have uterine cancer; the average age is 54 years. The 4th group consists of patients who are over 60 years of age with uterine cancer; the average age is 71 years. All patients were irradiated at the Oncological Clinic of České Budějovice Hospital. In my thesis, I compared the toxicity of radiotherapy in the group of younger patients with the group of the older patients. Hematological toxicity was more frequently identified in older patients, be it the malignant cervical cancer (76%) or the endometrial cancer (52%). In younger patients, hematological complications occurred less frequently (cervix {--} 52%, body of uterus {--} 24%). Serious grade 4 toxicity was identified in one patient over 60 years of age with separate pelvis radiotherapy for cervical cancer. Grade 3 toxicity was identified in one patient from the younger group and in one patient from the older group with combined treatment for cervical cancer. In regard to non-hematological complications, toxicity was more severe in older patients too. The incidence of diarrhea in the over 60-year-olds was 64% as opposed to 48% in the younger group. The stated hypothesis of higher toxicity of treatment for older patients was confirmed during my research.
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