Frequency and Relationship between Changes in Some Blood Factors and Acute Radiation-induced Skin Complications among Head and Neck Cancer Patients in Sanandaj in 2017”

Abstract

Background: Head and neck cancers account for 2 to 5% of body cancers and radiotherapy is one of the treatments for these conditions. Destroying cancer cells without damaging healthy cells around the tumor is very difficult. Cancer cells eventually die after repeated injuries by radiation in various treatment sessions, but unlike cancer cells, repair and replacement of normal cells happens between treatment sessions. In these patients, the most important complications are skin and blood complications. The occurrence of these complications may cause interruption of treatment by physicians’ order or patients’ request. Discontinuation of treatment may result in disturbance of tumor cells destruction that is the main purpose of radiotherapy. The high prevalence of head and neck cancer that are candidate for radiotherapy, and the increase use of electron beam therapy have made the occurrence of acute skin reactions and reduction of blood factors inevitable. In this cross-sectional study, we evaluated 60 patients include 22 female and 38 male patients who underwent neck and head radiotherapy from March 2017 to March 2018 in Sanandaj, west of Iran. For this purpose, by assessing the weekly blood tests, we evaluated blood cells changes. The rate and intensity of acute skin complications were recorded according to the RTOG ( radiation therapy oncology group) scoring system. Then, the collected data were entered into SPSS version 20 and ANOVA test was used for analysis. P-value<0.05 was considered statistically significant. Results: The evaluation of 60 patients' tests revealed that blood factor changes happen during radiotherapy. Mitotic catastrophes occur in blood cells and bone marrow suppression happens concurrently and without replacement. Regarding the radiation-induced skin complication, there is not a notable complication in the first weeks (first and second weeks), but from the late third week, these complications begin to manifest and continue to the tenth week, then the intensity mitigate and acute complications recover and became mild. In this study, the intensity of complications depends on the total and fractional delivery schedule doses. Conclusion: skin complications and blood factor changes occur during radiotherapy frequently. The changes of different blood factors are not the same and some of them can undergo decrease whereas increment happens in others.