Acute Side Effects of Radiation Therapy: A Guide to Management

Description

This book provides clear guidance on how to manage a wide range of side effects frequently encountered when treating patients with radiation therapy. For each potential side effect, incidence, mechanism, symptoms, and grading are carefully described. All aspects of management are addressed, drawing on the latest available evidence and highlighting key details of importance in clinical routine. The introduction of new radiation therapy techniques such as 3D conformal radiation therapy, intensity-modulated radiation therapy, and image-guided radiation therapy has reduced normal tissue doses and, accordingly, treatment complications. Nevertheless, a significant percentage of patients still experience acute side effects, in part because the threshold doses for these toxicities are typically lower than those for late effects. Acute toxicities may lead to interruption of treatment and be associated with an increase in late damage. A swift and effective response is therefore essential. This book will enable the reader to provide effective care for each side effect, thereby improving patient compliance with treatment and treatment outcomes.

Table of Contents

1. Introduction
2. Radiation Dermatitis
3. Mechanism
4. Timing
5. Sign and Symptoms
6. Scoring
7. Risk Factors
8. Treatment-Related Factors Including
9. Patient-Related Factors Include
10. Diagnosis
11. Prevention
12. General Measures
13. Intensity-Modulated Radiation Therapy (IMRT)
14. Low-Level Laser Therapy
15. Amifostine
16. Ascorbic Acid
17. Oral Zinc
18. Silver Leaf Dressing
19. MAS065D
20. Soft Dressing or Barrier Film
21. Hyaluronic Acid
22. Trolamine
23. Topical Sucralfate
24. Theta Cream
25. Dexpanthenol (Provitamin B5)
26. Calendula
27. Pentoxifylline
28. Aloe Vera
29. Deodorant
30. Laughter Therapy
31. Management
32. Grade 1 Dermatitis
33. Grade 2–3 Dermatitis
34. Grade 4 Dermatitis
35. References
36. Hair Loss
37. Mechanism
38. Timing
39. Risk Factors
40. Symptoms
41. Scoring
42. Prevention
43. Management
44. References
45. Radiation Brain Injury
46. Mechanism
47. Timing
48. Risk Factors
49. Treatment-Related Factors
50. Patient-Related Factor
51. Symptoms
52. Diagnosis
53. Scoring
54. Prevention and Management
55. Dexamethasone Prescription
56. References
57. Radiation Orbital Toxicity
58. Blepharitis and Eyelid Dermatitis
59. Eyelash Loss
60. Conjunctivitis
61. Xerophthalmia
62. Corneal Toxicity
63. Treatment
64. Topical Lubricants (e.g., Ophthalmic Ointment)
65. Analgesics
66. Ophthalmologist Consult
67. Iris Toxicity
68. References
69. Ear Toxicity
70. Mechanism
71. Timing
72. Risk Factors
73. Symptoms and Diagnosis
74. Scoring
75. Management
76. References
77. Oral Mucositis
78. Mechanism
79. Timing
80. Risk Factors
81. Tumor Site
82. Concomitant Systemic Therapy
83. Radiation Dose
84. Radiation Fractionation Schedule
85. Patient-Related Factors
86. Symptoms
87. Scoring
88. Prevention
89. Prophylactic Interventions
90. Prophylactic Intervention Under Evaluation
91. Management
92. Patient Assessment
93. Mouth Care
94. Management of Oral Pain
95. Benzydamine Mouth Wash
96. Doxepin
97. Magic Mouthwash
98. Gelclair
99. CAM2028
100. MF 5232
101. Acetylcysteine
102. Opiates
103. Corticosteroids
104. Gabapentin
105. Other Analgesic Agents
106. Sucralfate
107. Phenytoin Mouthwash
108. Low-Level Laser Therapy
109. Antifungals
110. Antivirals
111. Feeding Tube/Nutritional Support
112. References
113. Xerostomia
114. Mechanism
115. Timing
116. Risk Factors
117. Symptoms
118. Diagnosis
119. Scoring
120. Prevention
121. Amifostin
122. Prescription
123. Contraindications
124. Advers effects
125. IMRT
126. Submandibular gland transfer
127. Pilocarpine
128. Prescription
129. Contraindications
130. Acupuncture
131. Management
132. Supportive Care
133. Oral Rinses
134. Chewing to Stimulate Secretion of Residual Glandular Tissue
135. Maintaining Adequate Nutrition
136. Drink Adequate Fluids
137. Protection from Dry Lips
138. Alleviating Nocturnal Symptoms
139. Keeping Appropriate Oral Hygiene and Dental Care
140. Saliva Supplementation
141. Acupuncture
142. Drugs
143. References
144. Loss of Taste
145. Mechanism
146. Timing
147. Risk Factors
148. Symptoms
149. Diagnosis
150. Scoring
151. Prevention
152. Management
153. References
154. Laryngeal Edema
155. Mechanism
156. Timing
157. Risk Factors
158. Symptoms
159. Scoring
160. Prevention
161. Management
162. References
163. Radiation Pneumonitis
164. Mechanism
165. Timing
166. Risk Factors
167. Volume and Dose Parameters
168. Fractionation Schedule
169. Chemotherapy/Hormone Therapy
170. Smoking
171. Other Factors
172. Symptoms
173. Diagnosis
174. Scoring
175. Prevention
176. References
177. Pericarditis
178. Mechanism
179. Timing
180. Risk Factors
181. Symptoms
182. Diagnosis
183. Scoring
184. Prevention
185. Treatment
186. References
187. Esophagitis
188. Mechanism
189. Timing
190. Risk Factors
191. Symptoms
192. Scoring
193. Diagnosis
194. Prevention
195. Management
196. References
197. Radiation Gastritis
198. Mechanism
199. Risk Factors
200. Timing
201. Symptoms
202. Diagnosis
203. Prevention
204. Management
205. References
206. Radiation-Induced Liver Disease
207. Mechanism
208. Risk Factors
209. Timing
210. Symptoms
211. Scoring
212. Diagnosis
213. Prevention
214. Management
215. References
216. Enteritis
217. Mechanism
218. Timing
219. Risk Factors
220. Symptoms and Diagnosis
221. Scoring
222. Prevention
223. Management
224. Dietary Modification
225. Antidiarrheals
226. Antispasmodics
227. References
228. Radiation Cystitis
229. Mechanism
230. Timing
231. Risk Factors
232. Symptoms and Diagnosis
233. Scoring
234. Prevention
235. Bladder Sparing
236. Intravesical Instillation
237. Management
238. Anticholinergics
239. Alpha-1 Blocker
240. Analgesics
241. Intravesical GAG
242. References
243. Radiation Proctitis
244. Mechanism
245. Risk Factors
246. Timing
247. Symptoms
248. Scoring
249. Prevention
250. Management
251. References
252. Fatigue
253. Mechanism
254. Timing
255. Risk Factors
256. Symptoms
257. Diagnosis and Scoring
258. Management
259. Non-pharmacologic Interventions
260. Exercise
261. Counseling and Education
262. Optimize Sleep Quality
263. Complementary Therapies
264. Other Psychosocial Interventions
265. Nutrition Counseling
266. Pharmacologic Intervention
267. References
268. Hematological Side Effects
269. Mechanism
270. Timing
271. Risk Factors
272. Symptoms
273. Prevention
274. Treatment
275. Neutropenia
276. Thrombocytopenia
277. Anemia
278. References
279. Radiation-Induced Nausea and Vomiting (RINV)
280. Mechanism
281. Timing
282. Risk Factors
283. Symptoms
284. Prevention and Management
285. References
286. Index

Editors Biography

Ainaz Sourati received her MD from Gilan Medical School, Rasht, Iran in 2008. She subsequently undertook a Radiation Oncology residency at Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran (2011–4). The three years of the residency covered all oncology-related fields, including adult and pediatric oncology and theoretical and practical training in radiotherapy, chemotherapy, hormone therapy, and palliative care. She achieved first ranking in the National Iranian Boards Exam for Radiation Oncology in 2014. Dr. Sourati is currently working as a faculty member of the SBMU. She is also a member of the medical teaching method committee of the Educational Development Office at SBMU. Her main research interest is evaluation of radiation therapy side effects.

Ahmad Ameri graduated from Urmia Medical School, Azerbaijan, Iran, receiving his MD in 1993. He completed his specialization in Radiation Oncology at Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran in 2000, and achieved first ranking in the National Iranian Boards Exam for Radiation Oncology in 2001. He currently works as an associate professor and radiation oncology research deputy at SBMU. Dr. Ameri has been an active member of the Palliative Care Committee of the Health Ministry and is also one of the authors of the pain management guidelines for Iranian patients with malignancies, published in 2010. He has been editor in chief of the Iranian journal Reports in Radiation Oncology since 2013, and his present research focus is radiation therapy complications in patients with head and neck malignancies.

Mona Malekzadeh received her MD from Mashhad Medical School, Mashhad, Iran in 2000 and then completed Radiation Oncology residency training at Mashhad University (2004–7). She achieved first ranking in the National Iranian Boards Exam for Radiation Oncology in 2008. In 2011 she successfully completed a fellowship course at Loyola University of Medical Science that focused on modern techniques of radiotherapy under the supervision of Professor Bahman Emami. She is currently working as a faculty member of Shahid Beheshti University of Medical Sciences (SBMU), where she is also a member of the Educational Development Office. She has previously written a book in the Persian language for students of pharmacy. Dr. Malekzadeh’s research projects have included a double-blind trial on the treatment of radiation dermatitis and studies on the mental and psychological complications of oncologic treatment and the hormonal changes induced by pelvic radiotherapy.