Complications of pelvic radiation in patients treated for gynecologic malignancies |
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| Authors: | Akila N. Viswanathan MD MPH Larissa J. Lee MD Jairam R. Eswara MD Neil S. Horowitz MD Panagiotis A. Konstantinopoulos MD Kristina L. Mirabeau‐Beale MD Brent S. Rose MD Arvind G. von Keudell MD Jennifer Y. Wo MD |
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| Affiliation: | 1. Department of Radiation Oncology, Brigham and Women's Hospital and Dana‐Farber Cancer Institute, Boston, Massachusetts;2. Division of Urology, Washington University School of Medicine, St. Louis, Missouri;3. Division of Gynecologic Oncology, Brigham and Women's Hospital, Boston, Massachusetts;4. Department of Medical Oncology, Dana‐Farber Cancer Institute, Boston, Massachusetts;5. Harvard Radiation Oncology Residency Program, Boston, Massachusetts;6. Harvard Orthopedic Combined Residency Program, Boston, Massachusetts;7. Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts |
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| Abstract: | Radiation therapy is a critical treatment modality in the management of patients with gynecologic tumors. New highly conformal external‐beam and brachytherapy techniques have led to important reductions in recurrence and patient morbidity and mortality. However, patients who receive pelvic radiation for gynecologic malignancies may experience a unique constellation of toxicity because of the anatomic locations, combination with concurrent chemotherapy and/or surgery, as well as potential surgical interventions. Although side effects are often categorized into acute versus late toxicities, several late toxicities represent continuation and evolution of the same pathologic process. Comorbidities and radiation dose can significantly increase the risk of morbidity. Current understanding of the incidence of various morbidities in patients treated with current radiation techniques for gynecologic malignancies, the impact of chemotherapy and surgery, treatment options for those effects, and future areas of research are highlighted. Cancer 2014;120:3870–3883. © 2014 American Cancer Society. |
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| Keywords: | radiation morbidity toxicity gynecologic cancer |
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