Advance Search

Radiotherapy-induced changes in electrolyte levels and hematological parameters among endometrial cancer patients

Aliza Mikaeel Mustafa
Medical Physics Unit, Department of Pharmacology and Medical Physics and Clinical Biochemistry, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Fatiheea Fatihalla Hassan
Medical Physics Unit, Department of Pharmacology and Medical Physics and Clinical Biochemistry, College of Medicine, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Keywords:
Copyright and Licensing:

Copyright (c) 2026 Aliza Mikaeel Mustafa, Fatiheea Fatihalla Hassan (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Share:
Crossref
Scopus
Google Scholar
Europe PMC

Abstract

Background and Objective: Endometrial cancer, originating in the uterus's inner epithelial lining, is treated with radiotherapy, including external beam radiotherapy and brachytherapy. However, radiotherapy may disrupt electrolyte balance and affect blood components. This study aimed to evaluate the effect of radiation on hematological and electrolyte parameters in patients with endometrial cancer.

Methods: The study was conducted at the Awat Center, Erbil, Iraq, between December 25, 2024, and February 22, 2025, involving 25 patients. Blood samples were collected before, during, and after therapy, and parameter analyses were performed. The Elekta Infinity machine was used for curative treatment, including Volumetric Modulated Arc Therapy (VMAT). The local Ethics Committee approved the study and protocol.

Results: Radiotherapy significantly reduced white blood cell counts (WBC) from 6.94±2.59×10⁹/L before treatment to 4.70±1.45×10⁹/L during treatment (p <0.001), with partial recovery post-treatment (5.18±1.84×10⁹/L, p=0.001). Platelet counts also declined from 234.84±63.34×10³/μL to 199.08±47.69×10³/μL after radiotherapy (p=0.008). Hemoglobin, red blood cells, and most electrolytes (sodium, potassium, chloride, magnesium, phosphate) showed no significant variation. However, serum calcium levels declined modestly but significantly after radiotherapy (from 9.69±0.54 to 9.36±0.58 mg/dL, p=0.034).

Conclusion: Adjuvant VMAT radiotherapy in endometrial cancer patients induces significant hematological suppression, particularly of WBCs and platelets, while maintaining stable electrolyte levels. These findings highlight the hematologic sensitivity of pelvic radiotherapy and the importance of regular monitoring to reduce cytopenic risks.

PDF
PDF

Metrics

Metrics Loading ...

References

  1. Henley SJ, Ward EM, Scott S, Jim MA, Miller KD, Firth AU, et al. Annual report to the nation on the status of cancer, part I: national cancer statistics. Cancer. 2020;126(10):2225-49. https://doi.org/10.1002/cncr.32802
  2. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209-49. https://doi.org/10.3322/caac.21660
  3. Morice P, Leary A, Creutzberg C, Abu-Rustum N, Darai E. Endometrial cancer. Lancet. 2016;387:1094-108. https://doi.org/10.1016/S0140-6736(15)00130-0
  4. Siegel RL, Miller KD, Jemal A. Cancer statistics 2018. CA Cancer J Clin. 2018;68:7-30. https://doi.org/10.3322/caac.21442
  5. Rosenblatt E, Zubizarreta E; International Atomic Energy Agency. Radiotherapy in Cancer Care: Facing the Global Challenge. Vienna: International Atomic Energy Agency; 2017.
  6. Miller KD, Nogueira L, Devasia T, Mariotto AB, Yabroff KR, Jemal A, et al. Cancer treatment and survivorship statistics. CA Cancer J Clin. 2022;72(5):409-36. https://doi.org/10.3322/caac.21731
  7. Gianfaldoni S, Gianfaldoni R, Wollina U, Lotti J, Tchernev G, Lotti T. An overview of radiotherapy: from its history to its current applications in dermatology. Open Access Maced J Med Sci. 2017;5(4):521-5. https://doi.org/10.3889/oamjms.2017.122
  8. Komorowska D, Radzik T, Kalenik S, Rodaka A. Natural radiosensitizers in radiotherapy: cancer treatment by combining ionizing radiation with resveratrol. Int J Mol Sci. 2022;23:10627. https://doi.org/10.3390/ijms231810627
  9. Yosefof E, Kurman N, Yaniv D. The role of radiation therapy in the treatment of non-melanoma skin cancer. Cancers (Basel). 2023;15(9):2408. https://doi.org/10.3390/cancers15092408
  10. Shah C, Vicini F, Beriwal S, Thaker N, Frank SJ, Rossi P, et al. American Brachytherapy Society radiation oncology alternative payment model task force: quality measures and metrics for brachytherapy. Brachytherapy. 2022;21(1):63-74. https://doi.org/10.1016/j.brachy.2021.10.003
  11. Jin F, Luo HL, Zhou J, He YN, Liu XF, Zhong MS, et al. Cancer risk assessment in modern radiotherapy workflow with medical big data. Cancer Manag Res. 2018;10:665-75. https://doi.org/10.2147/CMAR.S164980
  12. Quirk S, Grendarova P, Roumeliotis M. Five-field IMRT class solutions and dosimetric planning guidelines for implementing accelerated partial breast irradiation. Pract Radiat Oncol. 2018;8(3):99-107. https://doi.org/10.1016/j.prro.2017.09.009
  13. Goswami B, Yadav S, Jain R, Goswami P. Volumetric modulated arc therapy for head and neck cancer: a dosimetric and treatment planning comparison with intensity modulated radiotherapy techniques. J Clin Diagn Res. 2021;16:XC05-9. https://doi.org/10.7860/JCDR/2021/47503.14661
  14. American Cancer Society. Treatment types [Internet]. 2022. https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types.html
  15. Abbassi LM, Arsene-Henry A, Amessis M, Kirova YM. Radiation dose to the low axilla in patients treated for early-stage breast cancer by loco-regional intensity-modulated radiotherapy (IMRT). Cancer Radiother. 2022;26(3):445-9. https://doi.org/10.1016/j.canrad.2021.06.002
  16. Kamal AS. The outcomes of induction chemotherapy, followed by neoadjuvant chemoradiotherapy and surgery, in locally advanced rectal cancer, single institute experience. Adv Med J. 2026;11(2):17-25. https://doi.org/10.56056/amj.2026.453
  17. Mohan G, Hamna A, Jijo J, Saradha M, Narayanasamy A, Balachandar V. Recent advances in radiotherapy and its associated side effects in cancer — a review. J Basic Appl Zool. 2019;80:83-5. https://doi.org/10.1186/s41936-019-0083-5
  18. Mahmood SQ, Talabany BK, Khoshnaw NS, Hamasoor T, Hussein ZS, Hassan M. Effects of radiotherapy on blood parameters in patients with different types of cancer; single center experience in Iraq. Iraqi J Hematol. 2024;13(1):90-4. https://doi.org/10.4103/ijh.ijh_1_24
  19. Swanson GP, Hammonds K, Jhavar S. Reference results for blood parameter changes and recovery after pelvic radiation without chemotherapy. Hematol Rep. 2022;14(2):155-64. https://doi.org/10.3390/hematolrep14020023
  20. Tawfeeq G, Tawfeeq RD, Ommar A, Ali S. Hematological changes after Röntgen ray exposure in radiologic technologists. Zanco J Med Sci. 2021;25(2):526-31. https://doi.org/10.15218/zjms.2021.032
  21. de Boer SM, Powell ME, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, et al. Toxicity and inflammatory response of radiotherapy in endometrial cancer. Cancers (Basel). 2020;12(12):3814. https://doi.org/10.3390/cancers12123814
  22. Guo J, Zhao Y, Zeng J, Tang E, Zhang Y, Wu L. Effect of prior adjuvant radiotherapy on immunotherapy outcomes in recurrent endometrial cancer. Int J Gynecol Cancer. 2025. https://doi.org/10.1016/j.ijgc.2025.101937
  23. Chen CC, et al. Impact of adjuvant radiotherapy on the survival of women with optimally resected stage III endometrial cancer in the era of modern radiotherapy. Radiat Oncol. 2020;15:14. https://doi.org/10.1186/s13014-020-01523-5
  24. Matei D, Filiaci V, Randall ME, Mutch D, Steinhoff MM, DiSilvestro PA, et al. Adjuvant chemotherapy plus radiation for locally advanced endometrial cancer. N Engl J Med. 2019;380:2317-26. https://doi.org/10.1056/NEJMoa1813181
  25. Li X, Yi Zh, Li M, Zhu Zh. Effects of radiotherapy on the survival of patients with stage IA and low-grade stage IB uterine endometrioid carcinoma. Sci Rep. 2023;13:46435. https://doi.org/10.1038/s41598-023-46435-y
  26. Lin YJ, Hu YW, Twu NF, Liu YM. The role of adjuvant radiotherapy in stage I endometrial cancer: a single-institution outcome. Taiwan J Obstet Gynecol. 2019;58(5):604-9. https://doi.org/10.1016/j.tjog.2019.07.005
  27. McGraw M. ASTRO guidelines of radiation therapy practices for endometrial cancer. Oncol Times. 2023;45(2):1,12. https://doi.org/10.1097/01.cot.0000918276.60544.8f
How to Cite
Mikaeel Mustafa, A., & Fatihalla Hassan, F. . (2026). Radiotherapy-induced changes in electrolyte levels and hematological parameters among endometrial cancer patients. Zanco Journal of Medical Sciences (ZJMS), 768–779. https://doi.org/10.15218/zjms.2026.055

Send mail to Author

Send Cancel