MEDICAL AND RADIOBIOLOGICAL ASPECTS OF RADIATION COMDPLICATIONS IN PATIENTS WITH ONCOGINECOLOGICAL PROFILE
DOI:
https://doi.org/10.15407/oncology.2023.01.009Keywords:
radiation complications, oncogynecological patients, T-lymphocytes of blood, aberrations of chromosomes, radiosensitivity, prognostic parameters.Abstract
Aim: to analyze the literature regarding the causes of the occurrence and features of distant complications of radiation therapy of cancer patients; investigation of the frequency and spectrum of spontaneous aberrations of chromosomes in the lymphocytes of peripheral blood of patients with oncogynecological profile (body cancer and cervix) before the onset of radiation therapy. Object and methods: peripheral blood lymphocyte test system with metaphase analysis of chromosome aberrations of 32 primary of cancer patients (follow-up group) and 30 conditionally healthy donors (comparison group). The examination of patients was performed before the onset of radiation therapy. Results: based on the analysis of literature data, the path to a personalized approach to the planning of radiation therapy for patients with oncogyne5 cological profile, the treatment of which is complicated by radiation lesions from the organs and tissues of the pelvis. The clinical and radiobiological aspects of the formation of radiation complications are considered in detail, the search for genetic indicators for the detection of patients with a high risk of developing radiation complications is justified. The results of cytogenetic examinations of patients with endometrial cancer and cervical cancer are close and indicate a 6-fold increase in the frequency of spontaneous chromosome aberrations compared to the population rate. In the spectrum of chromosomal restructures, complex restructures are recorded, which is uncharacteristic of the spontaneous level of aberration in healthy donors, as well as increased levels of chromatide type aberrations. Conclusions: the increased level of spontaneous chromosomal aberrations in T-lymphocytes of primary oncogynecological patients and the predominance of chromatid-type aberrations in the spectrum of registered chromosomal rearrangements indicate that genetic instability is formed in healthy cells before the start of radiation therapy, which predicts the risk of distant radiation complications, including the occurrence of secondary tumors radiation genesis. The examination of patients with the use of cytogenetic test will provide the most reasonable conclusion about the individual radio sensitivity of the patient to the onset of radiation therapy and will contribute to increasing its effectiveness, as well as improving the quality of life.
References
Fedorenko Z, Goulak L, Goroch E, et al. Cancer in Ukraine, 2004–2005. Incidence, mortality, activities of oncological service. Bull Natl Cancer Registr Ukr; Kyiv, 2006; (7): 96 p. (in Ukrainian).
Fedorenko Z, Goulak L, Michailovich Yu, et al. Cancer in Ukraine 2019–2020. Morbidity, mortality, indicators of the oncology service activity. Bull Natl Cancer Register Ukr; Kyiv, 2021; (22): 136 p. (in Ukrainian).
Mano M, Kerr J. Optimal therapy for relapsed carcinoma of the cervix after primary chemoradiation. J Clin Oncol 2004; 22 (24): 5021–2. doi: 10.1200/JCO.2004.04.283.
Ryu HS, Chun M, Chang K-H, et al. Postoperative adjuvant concurrent chemoradiotherapy improves survival rates for higt-risk, early stage cervical cancer patiente. Gynecol Oncol 2005; 96 (2): 490–5. doi: 10.1016/j.ygyno.2004.10.038.
Bhatla N, Aoki D, Sharma DN, et al. Cancer of the cervix uteri. Int J Gynecol Obstet 2018; 143 (2): 22–36. doi: 10.1002/ijgo.12611
Ivankova VS, Domina EA. Problems of tumor resistance in radiation oncology (сlinical and radiobiological aspects). Kyiv: Zdorov’ya, 2012. 192 p. .
Lerouge D, Touboul E, Lefranc JP, et al. Preoperative concurrent radiation therapy and chemotherapy for operable bulky cartinomas of uterine cervix stages IB2,IIA, and with proximal parametrial invasion. Cancer Radiother 2004; 8 (3): 168–77. doi: 10.1016/j.canrad.2004.02.002.
Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluationcriteria in solid tumors: revised RECIST guideline (version1.1). Eur J Cancer 2009; 45 (2): 228–47. doi: 10.1016/j.ejca.2008.10.026.
Semikoz NG, Shlopov VG. Radiation pathomorphosis of organs and tissues of the small pelvis in the treatment of cancer of the body and cervix. Donetsk: Kitis, 2000. 152p. .
Dynnyk OB, Kovalenko YuM, Sharmazanova OP. Problems of diagnostic radiology in Ukraine and ways to solve them. Radiolohichnyy visnyk: inform.-analit. byul. 2022; 80–81 (1–2): 26–30.
Radiation therapy in the treatment of cancer. Practical guide. Chapman& Hall, 2-6 Boundary Row, London SE 1 8 HN, UK, 2000. 338 p. .
Domina E. Expediency on using radiomitigators in radiation therapy of cancer patients. Journal of science. Lyon 2020; 1 (10): 7–11.
Domina E, Philchenkov A, Dubrovska A. Individual Response to Ionizing Radiation and Personalized Radiotherapy. Crit Rev Oncog 2018; 23 (1–2): 69–92. doi: 10.1615/CritRevOncog.2018026308.
Domina EA. Early and late radiation effects in healthy tissues of oncologic patients under therapeutic irradiations. Probl Radiac Med Radiobiol 2017; 22: 23–7. PMID: 29286495.
Gasinska A, Fowler JF, Lind BK, Urbanski K. Influence of overall treatment time and radiobiological parameters on biologically effective doses in cervical cancer patients treated with radiation therapy alone. Acta Oncol 2004; 43 (7): 657–66. doi: 10.1080/02841860410018511.
Domina EA. Radiogenic cancer: epidemiology and primary prevention. Kyiv: Naukova dumka, 2016. 196 p.
Zwaans BM, Nicolai HG, Chancellor MB, Lamb LE. Challenges and opportunities in Radiation-induced Hemorrhagic Cystitis. Rev Urol 2016; 18 (2): 57–65. doi: 10.3909/riu0700.
Kiechle JE, Kim SP, Yu JB, et al. Economic burden associated with hospitalization for radiation cystitis: Results from a statewide inpatient database. Urol Pract 2016; 3 (6): 437–42. doi: 10.1016/j.urpr.2015.10.007.
Mikhailenko VM, Domina EA, Ivankova VS, et al. Features of oxidative metabolism and genetic disorders in peripheral blood lymphocytes of primary cervical cancer patients. Exp Oncol 2022; 44 (3): 227–33. doi: 10.32471/exp-oncology.2312-8852.vol-44-no-3.18486.
Kopitsa NP, Rodionova YuV, Titarenko NV, et al. Features of damage to the cardiovascular system in COVID-19. Science Rise: Medical Science 2020; 3 (36): 4–12. doi: 10.15587/2519-4798.2020.204011.
Domina EA, Druzyna MO, Ryabchenko NM. Individual human radiosensitivity. Kyiv: Logos, 2006: 126 p. (in Ukrainian).
Chekhun VF, Domina EA. Can SARS-CoV-2 change individual radiation sensitivity of the patients recovered from COVID-19? (experimental and theoretical background). Exp Oncol 2021; 43 (3): 277–80. doi: 10.32471/exp-oncology.2312-8852.vol-43-no-3.16554.
Ke G, Liang L, Yang JM, et al. MiR-181a confers resistance of cervical cancer to radiation therapy through targeting the pro-apoptotic PRKCD gene. Oncogene 2013; 32 (25): 3019–27. doi: 10.1038/onc.2012.323.
Azria D., Ozsahin M., Kramar A, et al. Single nucleotide polymorphisms, apoptosis, and the development of severe late adverse effects after radiotherapy. Clin Cancer Res 2008; 14 (19): 6284–8. doi: 10.1158/1078-0432.CCR-08-0700.
Lacombe J, Azria D, Mange A, Solassol J. Proteomic approaches to identify biomarkers predictive of radiotherapy outcomes. Expert Rev Proteomics 2013; 10. (1): 33–42. doi: 10.1586/epr.12.68.
Halimi M, Asghari SM, Sariri R, et al. Cellular response to ionizing radiation: a microRNA story. Int J Mol Cell Med 2012; 1 (4): 178–84. PMID: 24551775.
Cellini F, Morganti AG, Genovesi D, et al. Role of microRNA in response to ionizing radiations: evidences and potential impact on clinical practice for radiotherapy. Molecules 2014; 19 (4): 5379–401. doi: 10.3390/molecules19045379.
de Candia P, Torri A, Pagani M, Abrignani S. Serum microRNAs as biomarkers of human lymphocyte activation in health and disease. Front Immunol. 2014; 5: 43. doi: 10.3389/fimmu.2014.00043.
Berezhnaya NM, Chekhun VF. Immunology of malignant growth. Kyiv: Nauk. Dumka, 2005. 792 p. .
