Follow-up/Toxicity

Question 1

What is the RT tolerance of proximal and distal vagina?

Answer 1

The RT tolerance of the mucosa of the proximal vagina is 120 Gy and distal vagina is 98 Gy. (Hintz BL et al., IJROBP 1980)

Question 2

At what RT dose does ovarian failure occur?

Answer 2

Ovarian failure occurs after 5–10 Gy.

Question 3

At what RT dose does sterilization occur in women?

Answer 3

Sterilization in women occurs after 2–3 Gy.

Question 4

What are the expected acute and late RT toxicities associated with RT Tx for endometrial cancer?

Answer 4

Acute toxicities: diarrhea, proctitis, abdominal cramps, fatigue, bladder irritation, drop in blood counts, n/v

Late toxicities: vaginal dryness and atrophy, pubic hair loss, vaginal stenosis and fibrosis (recommend vaginal dilators), urethral stricture, fistula formation, SBO, chronic urinary and bowel frequency, and secondary malignancy.

Question 5

What is the recommended f/u schedule post Tx per NCCN (2018)?

Answer 5

Exam q3–6 mos for 2–3 yrs, then q6–12 mos; CA125 only if initially elevated and imaging if clinically indicated.