Analysis of the Clinical-Epidemiological Profile and Cytopathological Follow-Up of Women with Cervical Cancer Undergoing Radiotherapy

Abstract

he objectives of this study were to identify the clinical-epidemiological profile of patients undergoing radiotherapy for malignant neoplasia of the cervix; describe the main cytological changes induced by radiation during post-radiotherapy follow-up; verify the incidence of locoregional recurrence, according to the cytopathological diagnosis and identify the disease-free survival and overall survival of patients followed in the study. The methodological design had a descriptive approach with a quantitative nature and longitudinal character, whose population was composed of 407 patients with cervical cancer who underwent radiotherapy and were followed up for a minimum of 5 years and a maximum of 7 years. The project was approved by the Research Ethics Committee of the National Cancer Institute, Rio de Janeiro, Brazil. Sociodemographic variables and associated risk factors were evaluated; categorical variables (cytopathological) and dependent variables for the outcome of locoregional recurrence, death and disease-free survival. The epidemiological profile of the study population revealed a mean age of 51 years, with an age range primarily from 41 to 50 years, with risk factors associated with smoking being present in 32% of patients. The percentage of alcoholics was just 5.5%. Regarding the number of sexual partners, the average was 4 partners throughout life. Squamous cell carcinoma was the most common histological type (84%). Regarding clinical staging, 2B (42.9%) and 3B (33.7%) were predominant. Of the exams with satisfactory quality for analysis, more than half (64.9%) showed actinic effects. The incidence of locoregional recurrence, according to the cytopathological diagnosis, was 11.8%, of which almost half (47.9%) died. The analysis of locoregional recurrence that impacts disease-free survival was 69.5%. The overall survival found in the analyzed population was 75.7%. The difficulties related to actinic (radiotherapy) effects show the importance of the experience of professionals involved in the analysis of irradiated cells and reflection on the subjectivity of the method. Observing these changes is useful for evaluating the impact of actions taken during the period and planning future actions.