Background: Worldwide Cervical cancer is the fourth most common diagnosed cancer and the fourth leading cause of cancer death in women with estimate of 604,000 new cases and 342,000 death respectively around 2020 (1).In Tanzania the incidence and mortality of cervical cancer reported to be 25.3% and 64 % respectively (2, 3). Radiotherapy is a main treatment of cervical cancer either definitive treatment or adjuvant therapy post-surgery. During radiation therapy for cervical cancer, 84% of patients experiences acute radiation toxicity. The most common acute toxicity presentations are hematological, gastrointestinal, dermatological and genitourinary toxicity. The severity of these acute toxicity depends on the dose per fraction, total radiation dose and the radiation technique applied (4). Most acute toxicity related with this treatment are under reported hence not addressed, Also there was little data of proportion and determinants of acute toxicity among cervical cancer patients undergoing curative radiotherapy at Bugando medical Centre in Lake Zone, Tanzania. Therefore, the study was to assess the prevalence and determinants of acute toxicity among cervical cancer patients undergoing curative radiotherapy at Bugando medical Centre
Method: Longitudinal follow up study design was used and 100 cervical cancer patients treated by radiotherapy at BMC were conservatively selected. Quantitative interviewer, observation, administered questionnaire was conducted for data collection and descriptive analysis of data was done using SPSS version 20.0.
Results: Total of 100 patients among cervical cancer patients undergoing curative radiotherapy, were included in the study. based on RTOG grading criteria. The most common gastrointestinal acute toxicity effect was diarrhea in 55%, (G1-2 was 48, G3-4 was 7%), followed by the urinary acute toxicity was 49.0% (G1-2 49%, with no grade 3-4), most common acute hematological toxicity was anemia in 33.1%, (G1- G2 was 30.1% and G3 -4 was 3%). Followed by nausea and vomiting in 29.5%, (where Grade 1-2 was 27.7%, G3 was 1. 8%) Most patients experienced acute dermatologic acute toxicity which was 46%(G1-2 was 42%, G3 was 4% with no G 4). Usually acute toxicity occurs in the second and third week of radiation therapy. Higher radiation dose was strong factor of increased hematological acute toxicity as well as gastrointestinal toxicity and age greater than 60 years for diarrhea. Chemo radiotherapy was found to have strong association with the acute hematological toxicities when compared with radiotherapy alone. Anemia in 67.0% (n=40/60) vs. 17.5 % (7/40)) were observed respectively that was statistically significant (p < 0.097).
Conclusion: The prevalence of acute toxicity among Cervical cancer patients undergoing curative radiotherapy was intermediate to high in this study. Majority of participants had acute toxicity (grades 1 and 2) which most occurred from second and third week of treatment. This study would help the radiotherapy team to identify the magnitude and determinants of acute toxicity among Cervical cancer patients undergoing curative radiotherapy at Bugando medical Centre. Also would help in health education programs to the patients to minimize the acute toxicity of cervical cancer patient treated by radiotherapy. Further, the results of the study would help other researcher to do more studies within or other areas to minimize the acute toxicity of cervical cancer related to radiotherapy.