Prevalence and Factors Associated With Late Effects of Radiotherapy Amongst Cervical Cancer Patients at Ocean Road Cancer Institute from 2016 to 2019

Abstract

Background: Cervical cancer prevails as the fourth most common diagnosed female cancer worldwide and the first in incidence and mortality amongst diagnosed cancers in Tanzania. Pelvic radiation therapy including both external beam radiation therapy and brachytherapy remains the main core treatment of cervical cancer. It has been associated with toxicities both acute and late, secondary to irradiation of the normal surrounding tissues. Frequently these effects are under-reported and inadequately addressed, since treatment success is usually defined in terms of tumor control and eradication than the long-term well-being of cervical cancer patients. Aim of the study: This study aimed at determining the prevalence and factors associated with late effects of radiotherapy amongst cervical cancer patients at Ocean Road Cancer Institute (ORCI), Dar es Salaam. Material and methods: This study employed a cross sectional designed study done at Ocean Road Cancer Institute. The study participants were patients with cervical cancer attending follow up clinic, at least six months after finishing curative pelvic radiotherapy. Chi-square test was used to assess factors associated with occurrence of late effects and multiple logistic regression was used to assess for confounding factors. Results: Three hundred and eight patients were recruited in this study. All participants had multiple late effects, the most common late effect was Genitourinary late effects (cystitis) (91.9%), followed by vaginal stenosis (dyspareunia, vaginal narrowing) (87.3%), sexual dysfunction (79.2%) and Gastro intestinal late effects (proctitis and enteritis) (72.19%) respectively. Majority of late effects were grade1-2(mild to moderate).Vaginal stenosis and sexual dysfunction late effects were significantly associated with age and EBRT field size (p<0.05).Smoking showed a statistically significant association with Genital Urinary late effects. Conclusion: The prevalence of radiotherapy induced late effects in cervical cancer patients was high in this study. Majority of participants had mild late effects (grades 1 and 2).