Acute and long-term toxicity following radiotherapy alone or in combination with chemotherapy for locally advanced cervical cancer

JH Maduro, E Pras, PHB Willemse, EGE de Vries*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

106 Citations (Scopus)

Abstract

Randomised studies in locally advanced cervical cancer patients showed that cisplatin should be given concurrently with radiotherapy, because of a better long-term survival compared to radiotherapy alone. This increases the relevance of treatment related toxicity. This review summarises the acute and long-term toxicity of radiotherapy given with or without chemotherapy for cervical cancer. Acute toxicity (all grades) of radiotherapy is reported in 61% of the patients in the rectosigmoid, in 27% as urological, in 27% as skin and in 20% as gynaecological toxicity. Moderate and severe morbidity consists of 5% to 7% gastrointestinal and 1% to 4% genitourinary toxicity. Adding chemotherapy to radiotherapy increases acute haematological toxicity to 5% to 37% of the patients and nausea and vomiting in 12% to 14%. Late effects of radiotherapy include gastrointestinal, urological, female reproductive tract, skeletal and vascular toxicity, secondary malignancies and quality of life issues. For at least 20 years after treatment, new side effects may develop. Gastrointestinal toxicity usually occurs in the first 2 years after treatment in about 10% of the patients. The incidence of moderate and severe urological toxicity can increase up to 10% and rises over time. Gynaecological toxicity usually occurs shortly after treatment while skeletal and vascular toxicity can occur years to decades later. Thus far, no increase in late toxicity has been observed after the addition of cisplatin to radiotherapy. Finally, methods to prevent or decrease late toxicity and therapeutical options are discussed. However, most randomised studies still have a limited follow-up period. (C) 2003 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)471-488
Number of pages18
JournalCANCER TREATMENT REVIEWS
Volume29
Issue number6
DOIs
Publication statusPublished - Dec-2003

Keywords

  • cervical cancer
  • radiotherapy
  • chemotherapy
  • side effects
  • SQUAMOUS-CELL CARCINOMA
  • PELVIC RADIATION-THERAPY
  • ATHEROSCLEROTIC OCCLUSIVE DISEASE
  • NONSEMINOMATOUS TESTICULAR CANCER
  • FRACTURES FOLLOWING IRRADIATION
  • CISPLATIN-BASED CHEMOTHERAPY
  • GYNECOLOGIC-ONCOLOGY-GROUP
  • FRANCO-ITALIAN GLOSSARY
  • QUALITY-OF-LIFE
  • UTERINE CERVIX

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