Correction of neurological side effects of taxanes by Meditan in patients with breast cancer
Summary. Vast majority of evidence suggest negative impact of radiation therapy on anal sphincter (AS) function. On the other hand, morphologic changes, which lead to anal incontinence after applying different programs of neoadjuvant radiation therapy (NRT), remain unrevealed. The aim of this study was to assess histologic changes in the AS, occurring after applying different regimens of NRT in combined treatment of rectal malignancies. Histologic changes in AS tissues were analyzed in 49 patients after NRT and abdomino-perineal extirpation. Twelve patients had been given a course of NRT with total dose of 20 Gy by gross fractions, 14 patients — 30 Gy by divided fractions, 30 patients — 50–60 Gy by divided fractions. A control group consisted of 10 patients, who didn’t undergo NRT. Grade I fibrosis was observed predominantly in groups of 20 and 30 Gy — 75,1 and 64,3% respectively. Among groups of 50–60 Gy grade II–III fibrosis was observed in 46,2 and 30,7% respectively. A tendency towards decreasing the number of nervous elements when increasing the dose of NRT was observed, but the difference appeared to be insignificant (р=0,28). Due to an alteration, caused by radiation therapy, degenerative and inflammatory changes occur in the AS tissue, which lead to substitution of muscular elements by fibrous tissue and turn out to be a morphological substance for further functional changes.
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