Radiation Side Effects and Syndromes: Difference between revisions
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The radiation may be delievered by a machine outside the body (external-beam radiation therapy) or it may come from radioactive material placed in the body (internal radiation therapy, also called brachytherapy).<ref name="NCI Radiation Therapy">National Cancer Institute. Radiation Therapy for Cancer. National Institutes of Health. http://www.cancer.gov/cancertopics/factsheet/Therapy/radiation. Reviewed May 30, 2010. Accessed April 3, 2013.</ref> | The radiation may be delievered by a machine outside the body (external-beam radiation therapy) or it may come from radioactive material placed in the body (internal radiation therapy, also called brachytherapy).<ref name="NCI Radiation Therapy">National Cancer Institute. Radiation Therapy for Cancer. National Institutes of Health. http://www.cancer.gov/cancertopics/factsheet/Therapy/radiation. Reviewed May 30, 2010. Accessed April 3, 2013.</ref> | ||
Type of radiation used depends on: | Type of radiation used depends on:<br>• Type of cancer<br>• Size<br>• Location<br>• How close the cancer is to normal tissues<br>• How far the radiation needs to travel<br>• General health and medical history<br>• Other types of treatment<br>• Age and other medical conditions | ||
<br>'''External-beam radiation therapy''': most often delivered in the form of photon beams (x-rays or gamma rays)< | <br>'''External-beam radiation therapy''': most often delivered in the form of photon beams (x-rays or gamma rays) <ref name="NCI Radiation Therapy" /> | ||
3-Dimensional Conformal Radiation Therapy (3D-CRT): most common type | 3-Dimensional Conformal Radiation Therapy (3D-CRT): most common type | ||
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• Deposit much of their energy at the end of their path (Bragg peak) and deposit less energy along the way<br> • Should reduce the exposure of normal tissue | • Deposit much of their energy at the end of their path (Bragg peak) and deposit less energy along the way<br> • Should reduce the exposure of normal tissue | ||
'''Internal-beam radiation therapy (Brachytherapy):< | '''Internal-beam radiation therapy (Brachytherapy):''' <ref name="NCI Radiation Therapy" /> | ||
Interstitial: uses radiation source placed within tumor tissue | Interstitial: uses radiation source placed within tumor tissue | ||
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• Carrier and the radiation sources are removed after treatment<br> • Can be either low-dose or high-dose | • Carrier and the radiation sources are removed after treatment<br> • Can be either low-dose or high-dose | ||
'''Systemic Radiation Therapy< | '''Systemic Radiation Therapy''' <ref name="NCI Radiation Therapy" /> | ||
Swallows or receives an injection of a radioactive substance or a radioactive substance bound to a monoclonal antibody | Swallows or receives an injection of a radioactive substance or a radioactive substance bound to a monoclonal antibody | ||
Revision as of 16:26, 10 April 2013
Original Editors -Alicia Dupilka & Kristin Gramling from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description[edit | edit source]
Radiation therapy is when radiation is delivered to a specific area of the body to try and treat a disease, usually cancer. The goal of the radiation is to kill rapidly dividing cancer cells while sparing slower dividing somatic cells.[1] Radiation is usually used in conjuction with surgery or chemotherapy.
The radiation may be delievered by a machine outside the body (external-beam radiation therapy) or it may come from radioactive material placed in the body (internal radiation therapy, also called brachytherapy).[2]
Type of radiation used depends on:
• Type of cancer
• Size
• Location
• How close the cancer is to normal tissues
• How far the radiation needs to travel
• General health and medical history
• Other types of treatment
• Age and other medical conditions
External-beam radiation therapy: most often delivered in the form of photon beams (x-rays or gamma rays) [2]
3-Dimensional Conformal Radiation Therapy (3D-CRT): most common type
Intensity-Modulated Radiation Therapy (IMRT)
• Dosage is chosen for different areas of the tumor and surrounding tissues
• High-powered computer program calculates the required number of beams and angles
• Goal: increase the dose to areas that need it and reduce exposure to sensitive areas
• Can reduce the risk of some side effects
• Larger volume of normal tissue overall is exposed
Image-Guided Radiation Therapy (IGRT)
• Repeated imaging scans performed during treatment
• Can increase the accuracy and may allow reduction in planned volume of tissue to be treated
• Decreasing total radiation dose to normal tissue
Tomotherapy
• Type of image-guided IMRT
• Hybrid between a CT and an external-beam radiation therapy machine
• Sparing normal tissue from high radiation doses
Stereotactic Radiosurgery
• Can deliver one or more high doses of radiation to a small tumor
• Extremely accurate image-guided tumor targeting and positioning
• High dose of radiation can be delivered without excess damage to normal tissue
Stereotactic Body Radiation Therapy
• Radiation therapy in fewer sessions
• Uses smaller radiation fields and higher
• Treats tumors that lie outside the brain and spinal cord
• Usually given more than one dose
• Can treat only small, isolated tumors; including cancers in the lung and liver
Proton Therapy
• Deposit much of their energy at the end of their path (Bragg peak) and deposit less energy along the way
• Should reduce the exposure of normal tissue
Internal-beam radiation therapy (Brachytherapy): [2]
Interstitial: uses radiation source placed within tumor tissue
Intracavitary: uses a source placed within a surgical cavity or a body cavity
Episcleral: used to treat melanoma inside the eye, uses a source that is attached to the eye
Low-dose: recieve continuous low-dose radiation over a period of several days
High-dose: robotic machine attached to delivery tubes placed inside the body, can be given in one or more treatment session, cause less damage to normal tissue
Placement is either permanent or temporary
Permanent
•Surgically sealed within the body and left
• Remaining material does not cause any discomfort or harm
• Low-dose rate
Temporary
• Carrier and the radiation sources are removed after treatment
• Can be either low-dose or high-dose
Systemic Radiation Therapy [2]
Swallows or receives an injection of a radioactive substance or a radioactive substance bound to a monoclonal antibody
Examples: radioactive iodine, ibritumomab tiuxetan (Zevalin®), combined tositumomab and iodine I 131 tositumomab (Bexxar®), samarium-153-lexidronam (Quadramet®), and strontium-89 chloride (Metastron®)
Prevalence[edit | edit source]
Nearly two-thirds of all cancer patients will recieve radiation therapy.[3]
Characteristics/Clinical Presentation[edit | edit source]
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Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Cause[3][edit | edit source]
Risk Factors:
Dependent on organ radiated, individual tolerance, tumor type, volume radiated and fraction size/dosage.
Neurotoxicity
- High total dose and fractionation dose
- Large volume radiated
- Increased edema
- Age <12 or >60 years
- Concurrent chemotherapy
- Underlying diseases affecting the vascular structures (Diabetes, HTN)
- Stereotactic radiation surgery and brachytherapy (internal radiation)
Dermatitis
- Total dose/volume and fractionation dose
- Surface area exposed
Acute Enterocolitis
- Large volume
- High total dose and fractionation dose
- Concurrent chemotherapy
Chronic Entercolitis
- Older age
- Postoperative radiation
- Presence of collagen vascular disease
- Concurrent chemotherapy
- Poor radiation technique
Pulmonary
- Older age
- Lower performance status
- Lower pulmonary baseline function
- Large volume treated
Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
see adding references tutorial.
- ↑ Stubblefield MD. Radiation Fibrosis Syndrome: Neuromuscular and Musculoskeletal Complications in Cancer Survivors. PM R 2011;3:1041-1054.
- ↑ 2.0 2.1 2.2 2.3 National Cancer Institute. Radiation Therapy for Cancer. National Institutes of Health. http://www.cancer.gov/cancertopics/factsheet/Therapy/radiation. Reviewed May 30, 2010. Accessed April 3, 2013.
- ↑ 3.0 3.1 Goodman CC, Fuller KS. Pathology: Implications for the Physical Therapist. 3rd ed. St. Louis. Missouri: Saunders, 2009.
