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Contribution of Chemotherapy to the Toxicity of Pelvic Irradiation

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Radiation Therapy for Pelvic Malignancy and its Consequences

Abstract

Pelvic malignancies encompass a diverse group of diseases and account for enormous morbidity and mortality worldwide. Given the established role of surgery and with better understanding of the potential synergy between chemotherapy and radiation, an era of combined modality therapy for these malignancies began to emerge in the 1990s. Many single institution and intergroup trials were conducted, establishing the role of combined modality therapy in pelvic malignancies by showing an improved survival, offering organ preservation and limiting surgical complications. However, these benefits accrued at the cost of increased acute toxicities as a result of the combined chemoradiation therapy. Interestingly, limited data suggest no significant increase in late/chronic toxicities, but ongoing and stringent follow-up will be critical to accurately define this issue which is of major interest to all cancer survivors. In the presence of limited data, it would be safe to assume that there is a higher rate of late toxicities given increased early effects lead to increased late effects and perhaps we would have seen these finding if the landmark chemoradiation trials would have collected data on late toxicities. In this chapter, we will review the currently existent literature on acute and late toxicities encountered by combining chemotherapy with radiation in the comprehensive therapy of pelvic malignancies.

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Abbreviations

CRT:

Chemoradiation

CT:

Chemotherapy

OS:

Overall Survival

DFS:

Disease-Free Survival

RTOG:

Radiation Therapy Oncology Group

EORTC:

European Organization for Research and Treatment of Cancer

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Authors and Affiliations

  1. Department of Medicine, Section of Hematology Oncology, University of Chicago, Chicago, IL, USA

    Amikar Sehdev MD, MPH

  2. Department of Medicine, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, 1 Highland Park Hospital, 777 Park Avenue West, Highland Park, IL, USA

    R. de W. Marsh MD FACP

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  1. Amikar Sehdev MD, MPH
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Correspondence to R. de W. Marsh MD FACP .

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Editors and Affiliations

  1. University of Chicago Medical School, NorthShore University Health System, Highland Park, Illinois, USA

    Eli Daniel Ehrenpreis

  2. University of Chicago Pritzker School of Medicine, NorthShore University Health System, Highland Park, Illinois, USA

    R de W Marsh

  3. Department of Radiation Oncology, Stritch School of Medicine, Loyola University, Chicago, Illinois, USA

    William Small Jr.

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Sehdev, A., de W. Marsh, R. (2015). Contribution of Chemotherapy to the Toxicity of Pelvic Irradiation. In: Ehrenpreis, E., Marsh, R., Small Jr., W. (eds) Radiation Therapy for Pelvic Malignancy and its Consequences. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2217-8_6

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