REPORTING RADIOTHERAPEUTIC COMPLICATIONS IN PATIENTS WITH UTERINE CERVICAL-CANCER - THE IMPORTANCE OF LATENCY AND CLASSIFICATION-SYSTEM

Radiotherapeutic morbidity is reported, according to our own system (A ADK) and the Franco-Italian glossary (FI) in 442 patients with cervica l cancer FIGO stage IIB (139), IIIA (10), IIIB (221), and IVA (72). Th e AADK system records each symptom, date of appearance, the required t herapy, and its initial date. FI describes the maximal damage in 4 gra des. Actuarial estimates of moderate or worse complications in the rec tosigmoideum differed significantly in relation to stage, while freque ncies did not differ. Frequencies were up to 25% lower than the actuar ial estimates. Moderate AADK complications in the rectosigmoideum occu rred from 1 to more than 24 months in 42% of stage IIIB patients final ly developing severe FI complications, and during more than 2 years in 24% of the patients dying from rectosigmoid complications. An analysi s of the probability of being alive without moderate or worse AADK com plications indicated that survival and complications were unrelated. I t is concluded that, with any classification system for reporting morb idity, each symptom and required therapy used in the definition of eac h complication grade and the date of appearance should be registered r egularly to allow (1) reporting of the real risk of organ damage, (2) rescoring of complication grades, (3) separation of early and late mor bidity, and (4) reporting of actuarial estimates. If these minimum req uirements are met, underestimation of morbidity is avoided.