Akila viswanathan4/4/2023 Recent genome-wide association studies (GWAS) have analyzed single-nucleotide polymorphisms (SNPs) and identified those that may be associated with GI toxicity, including 1 region of chromosome 11q14.3 associated with rectal bleeding in prostate cancer. 6, 7Ī validated preradiation biomarker-assessment tool to determine the risk of future enteritis is not available. 5 Most recently, the use of image-guided and high-dose-rate (HDR) brachytherapy has significantly reduced overall long-term complication rates from 22.7% to 2.6%. 2 Late toxicities are less common, and significant gastrointestinal (GI) symptoms (Common Terminology Criteria for Adverse Events grade ≥3) range from 3% to 8% of patients who receive postoperative treatment to the pelvis 3, 4 and up to 20% of patients with locally advanced and unresectable tumors who require external-beam RT (EBRT) with both dose escalation and brachytherapy. One prospective trial demonstrated that approximately 30% of postoperative patients with endometrial cancer who received radiation therapy (RT) experienced acute diarrhea, which persisted in approximately 10% of patients up to 5 years after treatment. Gastrointestinal Complications of Pelvic Radiation Incidence of gastrointestinal complications In this article, we highlight novel techniques for treating radiation-related morbidities as well as the role of surgical and medical management. 1 Although multimodality therapy may be curative, morbidity because of treatment presents a significant concern to patients, health care providers, and society. © 2014 American Cancer Society.Īpproximately 94,890 women will be diagnosed with gynecologic cancer in the United States in 2014. 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. Comorbidities and radiation dose can significantly increase the risk of morbidity. Although side effects are often categorized into acute versus late toxicities, several late toxicities represent continuation and evolution of the same pathologic process. 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. New highly conformal external-beam and brachytherapy techniques have led to important reductions in recurrence and patient morbidity and mortality. Radiation therapy is a critical treatment modality in the management of patients with gynecologic tumors.
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