UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Radiation-induced bowel injury: the impact of radiotherapy on survivorship after treatment for gynaecological cancers

Kuku, S; Fragkos, C; McCormack, M; Forbes, A; (2013) Radiation-induced bowel injury: the impact of radiotherapy on survivorship after treatment for gynaecological cancers. British journal of cancer , 109 (6) pp. 1504-1512. 10.1038/bjc.2013.491. Green open access

[thumbnail of Radiation-induced bowel injury the impact of radiotherapy on survivorship after treatment for gynaecological cancers.pdf]
Preview
Text
Radiation-induced bowel injury the impact of radiotherapy on survivorship after treatment for gynaecological cancers.pdf - Accepted Version

Download (288kB) | Preview

Abstract

Background: The number of women surviving cancer who live with symptoms of bowel toxicity affecting their quality of life continues to rise. In this retrospective study, we sought to describe and analyse the presenting clinical features in our cohort, and evaluate possible predictors of severity and chronicity in women with radiation-induced bowel injury after treatment for cervical and endometrial cancers. Methods: Review of records of 541 women treated within the North London Gynaecological Cancer Network between 2003 and 2010 with radiotherapy with or without chemotherapy for cervical and endometrial cancer identified 152 women who reported significant new bowel symptoms after pelvic radiation. Results: Factor analysis showed that the 14 most common and important presenting symptoms could be ‘clustered’ into 3 groups with predictive significance for chronicity and severity of disease. Median follow-up for all patients was 60 months. Univariate analysis showed increasing age, smoking, extended field radiation, cervical cancer treatment and the need for surgical intervention to be significant predictors for severity of ongoing disease at last follow-up. On multivariate analysis, only age, cancer type (cervix) and symptom combinations/‘cluster’ of (bloating, flatulence, urgency, rectal bleeding and per-rectal mucus) were found to be significant predictors of disease severity. Fifteen (19%) women in the cervical cancer group had radiation-induced bowel injury requiring surgical intervention compared with five (6.7%) in the endometrial cancer group. Conclusion: Women with cervical cancer are younger and appear to suffer more severe symptoms of late bowel toxicity, whereas women treated for endometrial cancer suffer milder more chronic disease. The impact of radiation-induced bowel injury and the effect on cancer survivorship warrants further research into investigation of predictors of severe late toxicity. There is a need for prospective trials to aid early diagnosis, while identifying the underlying patho-physiological process of the bowel injury.

Type: Article
Title: Radiation-induced bowel injury: the impact of radiotherapy on survivorship after treatment for gynaecological cancers
Open access status: An open access version is available from UCL Discovery
DOI: 10.1038/bjc.2013.491
Publisher version: https://doi.org/10.1038/bjc.2013.491
Language: English
Additional information: This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons AttributionNonCommercial-Share Alike 3.0 Unported License.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Womens Cancer
URI: https://discovery.ucl.ac.uk/id/eprint/10129793
Downloads since deposit
0Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item