title: Frequency and Severity of Acute Toxicity of Pelvic Radiotherapy for Gynecological Cancer.
abstract: OBJECTIVE
  To determine the frequency and severity of acute toxicity of pelvic radiotherapy for gynecological cancer.
  
  
  METHODS
  A case series.
  
  
  METHODS
  Department of Oncology, The Aga Khan University Hospital, Karachi, from March 2011 to June 2012.
  
  
  METHODS
  A total of 99 patients with histologically proven uterine and cervical cancer, receiving radiation therapy, were enrolled into the study after informed consent on justification of inclusion and exclusion criteria. Patients were evaluated for the frequency and severity of pelvic radiotherapy’s side effects according to toxicity criteria based on RTOG/EORTC and CTC version 2 criteria at the start, during and at the end of treatment. The data was analyzed by using SPSS version 16.
  
  
  RESULTS
  Out of the 99 enrolled patients, 58 (58.6%) had uterine and 41 (41.4%) had cervical cancer. Mean age was 54.54 ± 10.29 years. Thirty-five (35.4%) patients received chemotherapy with RT. Mean RT dose was 60.72 ± 7.15 Gy. The most common gastrointestinal adverse effect was diarrhea in 64 (64.6%) followed by proctitis in 55 (55.5%), nausea in 33 (33.3%) and vomiting in 16 (16.2%) patients. Grade (G) 1 was the most frequently observed severity. The most common hematological toxicity was anemia in 37.8% (n=31/82) {(G1=18 (21.9%), G2=11 (13.4%), G3=2 (2.4%)} followed by thrombocytopenia in 22.8% (21/92) {(G1=16 (17.3%), G2=2 (2.1%), G3=3 (3.2%)} and neutropenia in 21 (21.2%) {(G1=12 (12.1%), G2=5 (5%), G3=3 (3%), G4=1 (1%)}. Urinary toxicity was observed in 49 (49.5%) patients. On stratification, chemotherapy and higher RT dose were strong predictor of increased hematological and upper gastrointestinal toxicity (p < 0.05) and age > 60 years for diarrhea (p < 0.05).
  
  
  CONCLUSIONS
  The frequency and severity of acute toxicity of pelvic radiotherapy in women with gynecologic cancers was found intermediate to high.
authors.affiliation: Department of Oncology, Section of Radiation Oncology, The Aga Khan University Hospital, Karachi.
authors.forename: Asim
authors.initials: A
authors.lastname: Hafiz
authors.affiliation: Department of Oncology, Section of Radiation Oncology, The Aga Khan University Hospital, Karachi.
authors.forename: Ahmed Nadeem
authors.initials: AN
authors.lastname: Abbasi
authors.affiliation: Department of Oncology, Section of Radiation Oncology, The Aga Khan University Hospital, Karachi.
authors.forename: Nasir
authors.initials: N
authors.lastname: Ali
authors.affiliation: Department of Oncology, Section of Radiation Oncology, The Aga Khan University Hospital, Karachi.
authors.forename: Khurshid Ahmed
authors.initials: KA
authors.lastname: Khan
authors.affiliation: Department of Oncology, Section of Radiation Oncology, The Aga Khan University Hospital, Karachi.
authors.forename: Bilal Mazhar
authors.initials: BM
authors.lastname: Qureshi
mesh_terms: D000005:Abdomen / Q000528:radiation effects; D000328:Adult; D000368:Aged; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010154:Pakistan / Q000453:epidemiology; D010388:Pelvis / Q000528:radiation effects*; D011349:Proctitis / Q000453:epidemiology / Q000209:etiology; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012307:Risk Factors; D012720:Severity of Illness Index; D023382:Toxicity Tests, Acute / Q000379:methods*; D001743:Urinary Bladder / Q000528:radiation effects; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*