Neda Nozari - Gastroenterologist, Yas Hospital, Tehran University of Medical Sciences

Introduction: Radiotherapy is one of the effective management methods for gynecological cancers. Gastrointestinal system is the most frequently observed systems to be affected by pelvic radiotherapy. The aim of this study was to determine the incidence rate of colon pathologies follow pelvic radiotherapy for gynecological cancers in our clinic. Methods: A total of 40 patients with histologically proven uterine and cervical cancer, receiving pelvic radiation therapy, who referred to the oncology clinic in Yas hospital were enrolled into the study. All patients underwent a total colonoscopy examination, and all sample of biopsies or retrieved polyps were reviewed by a gastrointestinal pathologist. Results: Out of the 40 enrolled patients, 21 (52.5%) had uterine and 19 (47.5%) had cervical cancer. Mean age was 51.4 ±8.3 years with the median age at diagnosis of 45 years. A total of 22 polyps were found in 15 patients (37.5%, 95% CI 22.73-54.20). Adenomatous polyps were found in 12 patients. 6 of those polyps were greater than 1 cm, five had tubulovillous histology. 36.4 % (n=8) of all polyps were deemed to be within the radiation field. 63.6% (n=14) of all polyps were found beyond the ascending colon. Five patients suffered from proctitis due to radiotherapy side effects. One patient had evidence of recurrence of the endometrial neoplastic lesion in colon pathology. Conclusion: 40% of women who screened had significant pathology. Our analysis provides confirmation of the CRC surveillance in women with gynecology cancer, particularly who treated with pelvic radiation.

Gynecological malignancies, radiotherapy, cervical cancer, endometrial cancer, colon.