Number Т. 9, № 4 (36) 2019

Comparative characteristics of homeostatic differences in patients with fibrotic and degenerative later radiation complexes of prouenvins

Hladkykh F.V., Kulinich G.V.

Summary. Resume. Radiation therapy is an important component of cervical cancer treatment, however, due to the peculiarities of cervical, rectum, bladder, ureter, and other synths. Practically all pelvic organs are exposed to radiation. This is a prerequisite for the development of local radiation damage to soft tissues and organs that enter the irradiation area. The aim is to conduct a comparative analysis of clinical and laboratory indicators of patients with late radiation complications of fibrotic and degenerative genesis after radiation therapy for cervical cancer to identify criteria for the prognosis of the vector of development of late radiation complications. Materials and methods. A retrospective analysis of 254 case histories of patients with malignant neoplasms of the cervix was performed. 73 case histories of patients were divided into two groups: f (41 patients) — patients with fibrotic late radiation complications after treatment and d (32 patients) — patients with degenerative late radiation complications after treatment. Results. Analysis of the dynamics of hematological parameters showed that against the background of radiation therapy in patients with cervical cancer with fibrotic late radiation complications was observed statistically significant increase in the number of erythrocytes by 5.7%, Hemoglobin by 9.1%, 3.9% by 3% and erythrocyte sedimentation rate by 33.3%, While in patients with degenerative late-onset complications similar indicators had the opposite tendency to change — erythrocyte count decreased by 6.3%, hemoglobin level decreased by 0.8%, Hematocrit decreased by 7.3% and erythrocyte sedimentation rate decreased by 16.7% relative to radiation therapy. In addition, it was found that the number of leukocytes tended to decrease in patients in both groups, but in patients with fibrotic late radiation complications twice exceeded the same indicator of patients with degenerative late radiation complications and were respectively 6.0 and 12.0%. Characterizing the dynamics of biochemical parameters of patients with cervical cancer with late radiation complications, it is worth noting that the cytolysis markers of alanine aminotransferase and aspartate aminotransferase had different vector of changes. Thus, in patients with fibrotic late radiation complications, the level of alanine aminotransferase increased by 10.1%, and aspartate aminotransferase — increased by 16.4%, while in patients with degenerative late radiation complications, the level of aspartic aminotransferase decreased by 7.4%. These changes are consistent with the data on the development of cytolysis syndrome on the background of degenerative late radiation complications. In addition, patients in both groups reported a combined decrease in bilirubin by 11.5 and 11.0%, respectively. It was also found that in patients with fibrotic late radiation complications with radiation therapy, the level of urea was statistically significantly increased by 35.7% and the level of creatinine by 6.5%. Conclusions. In patients with cervical cancer, fibrotic and degenerative late radiation complications were identified in 32.3 and 25.2%, respectively. Fibrotic late radiation complications are twice as common in patients with cervical cancer on the background of overweight than on the background of weight deficits — 24.4 and 12.2% of patients, respectively. The ratio of the chances of developing fibrotic late radiation complications relative to degenerative after the operative component of treatment is 2.8±0.49 (95% CІ 1.1–7.2).

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