Câncer de próstata: evolução clínica e radiossensibilidade

Abstract

Radiation therapy is one of the most widely used and effective treatment modalities for prostate cancer. Therapeutic planning aims to administer a radiation dose appropriate to the tumor volume while minimizing exposure to adjacent normal tissues, such as the bladder and rectum, since adverse reactions to radiation therapy are related to damage caused by ionizing radiation to normal tissues of organs at risk within the treatment field. However, a significant proportion of patients treated with radiation therapy may experience serious adverse effects in normal tissues during or after treatment. A literature review of the last 5 years on this topic was conducted using the PubMed database. Following a literature review, retrospective clinical data were collected through medical record analysis to assess the incidence and intensity of late side effects in 43 prostate cancer patients who underwent radiotherapy more than 13 years prior. The follow-up time was approximately 24 years (290.3 months). Urinary symptoms were the most common chronic complication, reported by 45.2% of patients, and included complaints such as dysuria, urinary incontinence, nocturia, hematuria, polyuria, pollakiuria, lower abdominal pain, and urinary urgency. In contrast, chronic bowel symptoms were significantly less frequent, with complaints recorded in only 4.7% of medical records. Late urinary symptoms were the most common chronic adverse effects among prostate cancer patients treated with radiotherapy, but with significant interpersonal variability in incidence, type of symptoms and intensity. A variation in individual radiosensitivity of genetic origin remains a hypothesis to be further evaluated.