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How does radiotherapy works?
• Mechanism of action:
radiation induce damage of tumour cell DNA, preventing cell division and causing cell death
Radiotherapy uses
Curative indications:Cervical cancer 52% 5 yr OS.
Bladder cancerAnal cancer
Endometrial cancerRectal cancer
Palliative indications:Any tumour type for pain and symptom control
Procedure for giving radiotherapy
DiagnosisDiagnosis
Radiotherapy planningRadiotherapy planning
Treatment deliveryTreatment delivery
Radiotherapy planning
• Patient positioning– Lasers– Tattoos– Immobilisation
• To ensure reproducibility in a multi-fraction radiotherapy course
Radiotherapy side effects
Early (Acute):Occur during the course of the treatmentRecover soon after the therapy is completed
Late (chronic):late radiation complications are due to small vessel injury with endothelial damage, inflammation, fibrosis, ischaemia and necrosis.Occur months to years after a course of radiotherapyTend’s to be permanent …..
Early Radiotherapy side effects
FatigueSkin desquamationDiarrhoeaLow blood countFrequency / cystitis
Late side effects
• Skin telangectasia• Vaginal stenosis
• Dilators• Late effects on bowels
(proctitis)• Bladder changes• Avascular necrosis of the
hip• Secondary cancer
Sexual morbidity
Sexual problems suffered by women with cervical cancer may include:
loss of libido change in sexual activity and decreased orgasm.
Up to 65% of women experience one or more of these problems due to
vaginal dryness or bleeding.Vaginal stenosis and dyspareunia. atrophic vaginitis and pain.
Summary
• Radiotherapy is effective in treating pelvic cancers.• Acute radiotherapy side effects recover shortly after
therapy ends.• Late effects tends be permanent and can take months
to years to manifest.• New radiotherapy techniques allows for better tumour
control with good sparing of normal tissues.