Common side effects of radiotherapy for cervical cancer

Radiotherapy is suitable for all stages of cervical cancer, including vaginal post-loading therapy and pelvic external irradiation. Because the cervix is ​​located near the bladder in front and the rectum in the back, while the radiation kills cancer cells, it also causes some damage to normal tissues. Tissue congestion, edema, and ulcers may occur, and in severe cases, necrosis and shedding may occur. In the late stage, fibrous tissue hyperplasia occurs, causing organ stenosis.

These reactions may occur during treatment or after radiotherapy. Common radiation reactions include fatigue, loss of appetite, bowel sounds, and frequent urination. Some patients may experience increased bowel movements, which can be relieved by symptomatic treatment. A small number of patients may experience anal prolapse during bowel movements, bloody stools with mucus, frequent urination, and urgency, as well as blood tests such as decreased portal cells or platelets. The treatment method is prevention first, and the radiotherapy plan should be correctly mastered, such as avoiding improper placement of the uterine cavity tube or its shedding into the vagina, resulting in excessive local radiation doses, tissue burns, and fistulas. If symptoms such as hematuria and bloody stools have already appeared. The following treatments should be given depending on the specific situation:

(1) Recent cystitis or proctitis: mainly symptomatic treatment, drinking plenty of water, giving hemostatics, antidiarrheals and antibiotics, which can generally heal on their own.

(2) Late urinary system complications: Radiation cystitis is the most common, with an incidence of 2% to 10%, and vesicovaginal fistula has an incidence of 1% to 3%. In some patients, pelvic fibrosis leads to ureteral obstruction and causes varying degrees of renal dysfunction. Late radiation cystitis is most common with hematuria, which is often manifested as sudden hematuria and often with fatigue. A full bladder causes rupture of the bladder mucosal blood vessels that are not elastic after radiotherapy. If the bladder is kept empty, symptomatic treatment can improve the condition, such as drinking plenty of water, eating more vegetables, taking antispasmodics and antibiotics, etc. In a few severe cases, antibiotics and hemostatics can be intravenously administered. Alternatively, bladder irrigation can often achieve a good hemostatic effect.

(3) Late intestinal complications: including radiation proctitis, sigmoiditis, rectovaginal fistula, intestinal adhesion, intestinal obstruction, intestinal perforation, etc. The severity is divided into three degrees: mild, moderate, and severe. Mild is mainly a small amount of blood in the stool; moderate is repeated large amounts of blood and mucus in the stool, accompanied by tenesmus; severe is more serious and develops into intestinal ulcers, stenosis, intestinal fistula, etc. No special treatment is required for mild patients; moderate is treated with anti-inflammatory, hemostatic, antispasmodic drugs, such as oral antibiotics; for severe blood in the stool, 10% epinephrine can be added to the enema solution 1 ml, which can quickly stop bleeding. Transverse colostomy can be performed for vaginal rectal fistula or severe intestinal ulcers, stenosis, intestinal obstruction and severe bleeding.