Anticoagulant use, older age predict radiation proctitis in chemoradiation-treated cervical cancer

Treatment with antiplatelet medications and age are some of the factors associated with the occurrence of radiation proctitis in patients with locally advanced cervical cancer treated by chemoradiation, a recent study has shown.

Among eligible patients, 59 (46.1 percent) underwent brachytherapy. The mean dose to the planning target volume was 47.1 Gy. Radiation proctitis developed in 16 patients (12.5 percent), with 12 (9.3 percent) having grade 2 or higher.

Univariate analysis revealed the significant association of anticoagulant or antiplatelet therapy (p=0.039), older age (p=0.049), and rectal volume irradiated at 40 Gy (p=0.01) and 30 Gy (p=0.037) with the development of grade ≥2 radiation proctitis. Additionally, the delivered dose to 2 cm³ of rectum appeared to be potentially correlated with the occurrence of radiation proctitis of all grades (p=0.064).

“This study highlights clinical and technical factors that should be considered in assessing the risk of radiation proctitis,” the investigators said. “These results contribute to a better understanding of this complication.”

Overall, 128 patients treated by exclusive chemoradiation or chemoradiation followed by brachytherapy for locally advanced cervical cancer from 2011 to 2017 were included in this analysis. The investigators performed a bivariate analysis to explore the relationship between the occurrence of radiation proctitis and several clinical and technical variables.

“Radiation proctitis is a misunderstanding complication of chemoradiation in locally advanced cervical cancer,” the investigators said.