Radiotherapy is a necessary and often used procedure in the treatment of gynecological câncer. However, this might have some adverse effects on the cervico-vaginal squamous epithelium after maximum therapeutic doses. At the following of patients treated for gynecologic cancer, cervical-vaginal cytopathologic is used as a tool in the evaluation of a possible vaginal recurrence. The current literature shows that some changes in the Pap exam mimicking pre-neoplastic and neoplastic changes in the squamous epithelium are often due to radiotherapy effect in this epithelium (actinic changes) and not themselves neoplastic changes. This project aims at assessing the actual meaning of cytological abnormalities in patients receiving pelvic radiotherapy and to identify the quantity of epithelial changes due to the effect of radiotherapy, or possibility of recurrence of the malignant tumor or a new genital lesion. There will be evaluation of the frequency of changes in squamous cells, related thes with the types of radiotherapy, age and type of tumor, as well as related to time after the end of radiotherapy. We will also evaluate the performance and intra-observer reproducibility of cytopathology tests in patients who received pelvic radiotherapy for cervical neoplasia. The study will be methodological assessment of the meaning and reproducibility of retrospective collections, with a sample of patients treated with pelvic radiotherapy and showed changes in cervicovaginal Pap smear and a sample of patients with radiotherapy without cytological abnormalities. Diagnostic procedures in these cases will be evaluated by gynecological examination, colposcopy examination, and anatomopathological of the highlighted changes and also further gynecological treatments. The student intends to follow some diagnostic assessments such as monitoring of the reading and analysis of the slides of citopathological and anatomopathological, and also monitoring of colposcopy examination, in order to understand and learn how it is done the diagnostic process of these patients. The project will be submitted for approval by the Ethics and Research Committee of the Barretos Cancer Hospital (CEP).
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