hematology and oncology
Radiation Therapy for Cancer
Adverse Effects of Radiation Therapy
Radiation can damage any intervening normal tissue. Acute adverse effectsdepend on the area receiving radiation and may include Lethargy Fatigue Mucositis Dermatologic manifestations (erythema, pruritus, desquamation) Esophagitis Pneumonitis Hepatitis Gastrointestinal symptoms (nausea, vomiting, diarrhea, tenesmus) Genitourinary symptoms (frequency, urgency, dysuria) Bone marrow suppression Late complicationsof radiation therapy include cataracts, keratitis, and retina damage if the eye is in the treatment field. Additional late complications include hypopituitarism, xerostomia, hypothyroidism, pneumonitis, pericarditis, esophageal stricture, hepatitis, ulcers, gastritis, nephritis, sterility, muscle contractures, and arteriosclerotic heart disease, depending upon the area treated. Radiation that reaches normal tissue can lead to poor healing of the tissues if further procedures or surgery is necessary. For example, radiation to the head and neck impairs recovery from dental procedures (eg, restoration, extraction) and thus should be given only after necessary dental work has been done. Radiation therapy can increase the risk of developing other cancers, particularly leukemias, sarcomas, and carcinomas of the thyroid or breast. Peak incidence occurs 5 to 20 years after exposure and depends on the patient's age at the time of treatment. For example, chest radiation therapy for Hodgkin lymphoma in adolescent girls leads to a higher risk of breast cancer than does the same treatment in adult women. 