Rare Radiation Complications after Treatment of Cervical Cancer

Abstract

Currently, cervical cancer is one of the most common types of oncological pathology. Radiation therapy is the main treatment for patients with locally advanced cervical cancer. The main goal of radiation treatment for cervical cancer is to plan the amount of radiation in which the primary tumor and the areas of regional lymph outflow are subject to the maximum possible impact with minimal radiation exposure to critical organs (rectum and bladder). However, the program of combined radiation therapy according to a radical program in patients with locally advanced cervical cancer provides for irradiation of sufficiently large volumes with high therapeutic doses. Radiation therapy with radiomodifying cytostatics or with competitive polychemotherapy improves both immediate and long-term results of treatment, but increases the risk of radiation reactions. According to clinical signs, radiation toxicity is divided into general and local, which, in turn, can be early and late, depending on the time of occurrence. The risk of radiation damage naturally increases with an increase in the total absorbed dose. The presence of comorbidities also affects the likelihood of post-radiation complications. Chronic diseases of organs located in the irradiated zone significantly increase the risk of their radiation damage. Individual radiosensitivity plays a decisive role in the occurrence of radiation complications. The article describes a case of a urinary-small intestinal fistula in patient A., 80 years old. The patient has been observed in the clinic of the State Organization «Grigoriev Institute for Medical Radiology and Oncology National Academy of Medical Sciences of Ukraine» since 2016 for cervical cancer FIGO IVA stage (pathohistological conclusion was squamous cell non-keratinizing cancer), a course of combined radiation therapy with modification of 5-fluorouracil under a radical program was carried out. The relapse-free period for cervical cancer was 4 years, the patient regularly underwent control examinations at the Institute's clinic. Since March 2020 has had complaints about the presence of feces in the urine, which is why she came to the clinic. Conclusion. Treatment of this category of patients is a difficult task that requires time and great effort from both medical staff and patients