WHAT ARE THE MOST SERIOUS ADVERSE EVENTS DURING AND AFTER RADIATION THERAPY?

1
WHAT ARE THE MOST SERIOUS ADVERSE EVENTS DURING
AND AFTER RADIATION THERAPY?

• Bhadrasain Vikram, MD

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GLIOBLASTOMAStupp, NEJM 352987-96, 2005.

• gtGrade 3 non-heme toxicity in 31. Most common
• Fatigue other constitutional symptoms
• Rashes other skin effects
• Infection
• Effects on vision
• Nausea Vomiting

3
HEAD NECKBonner, NEJM 354567-78, 2006.

• gtGrade 3 toxicity
• Mucosal 56
• Dysphagia 26
• Dermatitis 23
• Weight loss 11

4
SMALL CELL LUNG - LDTurrisi, NEJM 340265-71,
1999.

• gtGrade 3 non-heme toxicity
• Esophagitis in 32
• Infection
• Fever
• Vomiting
• Pulmonary effects
• Weight loss

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ESOPHAGUSMinsky, JCO 201167-74, 2002.

• gtGrade 3 acute toxicity in 71.
• gtGrade 3 late toxicity in 37.
• Esophageal strictures, perforations, bleeding.

6
BREAST POST-LUMPECTOMYFyles, NEJM 351963-970,
2004.

• gtGrade 3 toxicity
• Fatigue 1
• Skin erythema 1

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BREAST POST-MASTECTOMYRagaz, JNCI 97116-1126,
2005.

• gtGrade 3 late toxicity _at_ 20 years
• Cardiac 1
• Arm edema 6
• Symptomatic pneumonitis 0.6

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PANCREAS POST-OPRegine, JAMA 2991019-1026,
2008.

• gtGrade 3 non-heme toxicity in 58. Most
  common
• Diarrhea
• Stomatitis
• Nausea Vomiting

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PROSTATE LOW-RISKLawton, IJROBP 6739-47, 2007.

• gtGrade 3 acute toxicity
• GU bleeding/toxicity 8
• gtGrade 3 late toxicity
• Erectile dysfunction 9
• GU obstruction/retention 2

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PROSTATE HIGH-RISKBolla, Lancet 360103-108,
2002.

• gtGrade 3 toxicity
• Erectile dysfunction 68
• GI/GU toxicity 3.7

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CERVIXMorris, NEJM 3401137-1143, 1999.

• gtGrade 3 acute non-heme toxicity in 11. Most
  common
• Nausea vomiting
• Diarrhea
• gtGrade 3 late toxicity in 12. Most common
• Bowel Urinary toxicity

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RECTUMSauer, NEJM 3511731-1740, 2004.

• gtGrade 3 non-heme acute toxicity in 27. Most
  common
• Diarrhea
• Dermatitis
• gtGrade 3 late toxicity in 14. Most
  common
• Diarrhea
• Bowel obstruction/strictures
• Bladder problems

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ANALAjani, JAMA 2991914-1921, 2008.

• gtGrade 3 non-heme acute toxicity in 74. Most
  common
• Skin toxicity
• Bowel toxicity
• gtGrade 3 late toxicity in 11. Most
  common
• Bowel toxicity
• Skin Subcutaneous

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SUMMARY

• Serious adverse events frequently occur during
  and after radiation therapy in many common
  cancers.
• The impact of advanced technologies (IMRT,
  Protons, etc.) in that regard has until now been
  quite modest.