Genetic, clinical and environmental factors with a probable role for development of early radiation adverse events in cervical and endometrial cancer patients after postoperative pelvic irradiation
- Encheva, I. Yordanova, T. Lakov, A. Savov, I. Kremensky,V. Mitev, R. Kaneva, T. Hadjieva
Abstract. The aim of this study was to investigate the factors influencing the development of early radiation adverse events in cervical and endometrial cancer patients after postoperative radiotherapy. The study included 109 patients with cervical and endometrial carcinoma after radical surgery. External beam pelvic irradiation was performed on a Co-60 machine with “Box” technique to 50 Gy total dose in 2 Gy daily fractions. Early radiation adverse events were assessed according to Common Terminology Criteria for Adverse Events, v.3.0, for first time applied in Bulgaria by own designed questionnaire. Information on smoking habits, previous abdominal surgery, sensitivity to sunlight, family history, concomitant diseases was generated. DNA isolated from venous blood was used for genotype analysis with Polymerase Chain Reaction Fragment Length Polymorpisms (PCR-REFP). Standard statistical package and logistic regression analysis was applied for statistical evaluation. Only 2% of the patients did not developed any early radiation adverse events Majority of patients suffer grade 1 and 2 adverse events. No grade 4 and 5 events were recorded Smoking increases the grade of gastrointestinal events and the summarized clinical radiosensitivity Sensitivity to sunlight was associated with moderate and severe skin reactions. Genetic factors influence the severity of genitourinary (XRCC1 194 (C>T), XRCC1 280 (G>A)) and skin adverse events (XRCC1 194 (C>T), XRCC1 280 (G>A)) and also the summarized clinical radiosensitivity (XRCC1 194 (C>T)). The risk factors for development of early radiation adverse events found in the present study are smoking, sensitivity to sunlight and the following SNPs XRCC1 194 (C>T), XRCC1 280 (G>A) и XRCC1 194 (C>T), XRCC1 280 (G>A).
Key words: NORMAL TISSUE ADVERSE EVENTS. pREDICTIVE
MARKERS. MOLECULAR-GENETIC FACTORS