Follow-up/Toxicity Flashcards
List 3 procedure-related complications seen in cervical cancer intracavitary brachytherapy.
rocedure-related complications seen in cervical cancer intracavitary brachytherapy:
Uterine perforation (<3%) although some studies have rates >10%. US is recommended for guidance during insertion. (Small W. et al., Int J Gynecol Cancer 2011)
Vaginal laceration (<1%)
DVT (<1%)
Name the most common acute side effects associated with RT for cervical cancer.
Skin irritation, fatigue, hemorrhoids, colitis-diarrhea, cystitis-frequency/dysuria, and nausea are all possible acute side effects from cervical cancer RT.
Name the common long-term side effects associated with cervical cancer RT.
Common long-term side effects of cervical cancer RT include permanent alteration in bowel habit, menopause in the premenopausal age group, chronic cystitis with frequency, and vaginal stenosis with dyspareunia and postcoital bleeding. The major severe long-term toxicities are most commonly bowel related: rectosigmoid stenosis, requiring possible colostomy, and major rectal bleeding. Hematuria, ureteral stricture, fistula, SBO, and hip fracture or sacral insufficiency fracture can also occur.
What should pts do regularly to prevent vaginal stenosis after receiving RT for cervical cancer?
Routine use of a vaginal dilator is essential to preventing vaginal stenosis in pts who have undergone RT for cervical cancer.
What was the rate of fistula formation post RT and bevacizumab in GOG 240?
Fistula (any grade) occurred in 15% of pts treated with bevacizumab (1% in chemo alone group); all pts previously irradiated. (Tewari KS et al., Lancet 2017)
When after definitive Tx do you order imaging?
A PET/CT is ordered at 3 mos post Tx to assess response which is predictive of survival. If PR → Bx f/b Sg if + or local brachytherapy for small-volume Dz. If distant progressive Dz treat with chemo.
