Hematology and Oncology Book

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Radiation Therapy

Aka: Radiation Therapy, External Beam Radiation Therapy, Therapeutic Radiology Procedure, Radiotherapy, Radiation Oncology
  1. Types: External Beam Radiation Therapy
    1. Three-Dimensional Conformal Radiation Therapy
    2. Four-Dimensional Radiation Therapy
    3. Intensity-Modulated Radiation Therapy
    4. Stereotactic Radiosurgery (Gamma Knife)
    5. Stereotactic Body Radiation Therapy (Cyberknife)
  2. Types: Internal Radiation Therapy
    1. Brachytherapy
    2. Systemic Radiation Therapy (e.g. Iodine-131 for Thyroid Cancer)
  3. Adverse Effects: General
    1. See Cancer Survivor
    2. See Cancer Symptom
    3. See Radiation Dermatitis
    4. Adverse effects may manifest in hours to days and resolve over months
    5. Secondary cancers may not manifest for years
  4. Adverse Effects: Cardiopulmonary
    1. Cardiovascular Disease Risk
      1. Hodgkin's Lymphoma
      2. Breast Cancer
      3. Lung Cancer
      4. Adams (2003) Crit Rev Oncol Hematol 45(1):55-75 [PubMed]
    2. Pneumonitis
      1. Associated cancers
        1. Breast Cancer
        2. Lung Cancer
        3. Mediastinal radiation
      2. Risk factors
        1. Increased radiation dose and Lung Volume radiated
        2. Comorbid lung disease or baseline PFT abnormalities
      3. Management
        1. Corticosteroids
        2. Pentoxifylline (Trental)
  5. Adverse Effects: Gastrointestinal
    1. See Radiation Colitis
    2. Xerostomia
      1. Saliva substitute
      2. Pilocarpine
      3. Consider amifostine (Ethylol)
    3. Mucositis or Esophagitis
      1. See Oral Mucositis
      2. Viscous Lidocaine alone or in combination with "Magic Mouthwash" agents
      3. Responds to typical GERD precautions and Proton Pump Inhibitors
    4. Diarrhea
      1. Modify diet: Low residue, decrease dairy products
      2. Consider Imodium
    5. Proctitis
      1. Consider Sulfasalazine (Azulfidine) orally for prevention
      2. Consider sucralfate enema for chronic symptoms
    6. Vomiting
      1. See Vomiting in Cancer
      2. Zofran and other 5-HT3 Receptor Antagonists
      3. Metoclopramide (Reglan)
      4. Prochlorperazine (Compazine)
      5. Corticosteroids
  6. Adverse Effects: Genitourinary
    1. Cystitis
      1. Maximize hydration
      2. Uroprotective agents
    2. Erectile Dysfunction
      1. Consider Sildenafil (Viagra) and other phosphodiesterase type 5 inhibitors
    3. Vaginal Dryness
      1. Vaginal lubrication
      2. Consider vaginal dilation if stenosis (especially over age 50 years)
    4. Infertility and Teratogenicity
      1. Consider egg and sperm preservation prior to radiation and Chemotherapy
  7. Adverse Effects: Patient Contacts during Radiation Therapy
    1. External beam radiation
      1. No residual radiation risk (no contact restrictions)
    2. Temporary internal radioactive implant (catheter inserted and then withdrawn)
      1. Patient typically remains in hospital until implant withdrawn
      2. Children and pregnant women should avoid visiting patient while radioactive implants are present
    3. Permanent internal (brachiotherapy, radioactive see or pellet insertion at tumor region)
      1. Avoid contact with infants and pregnant women for days to months (implant specific)
      2. Also applies to young pets (puppies, kittens)
    4. Radioactive Iodine (Hyperthyroidism Management)
      1. Avoid bodily fluid contact for infants, children and pregnant women for several days
  8. Resources
    1. Radiation Therapy Patient Education (NCI)
      1. https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy
  9. References
    1. Berkey (2010) Am Fam Physician 82(4): 381-8 [PubMed]
    2. Higdon (2018) Am Fam Physician 97(11):741-8 [PubMed]

External Beam Radiation Therapy (C1517033)

Definition (NCI) Radiation therapy in which high-energy beams are delivered to the tumor from outside of the body.
Definition (NCI_NCI-GLOSS) A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body.
Concepts Therapeutic or Preventive Procedure (T061)
ICD10 U006288
English external beam radiation therapy, external beam radiation therapy (treatment), external beam radiation, external radiation, Radiation Oncology Procedures: External Beam Therapy, External Beam Radiation Therapy, External Radiation Therapy, external-beam radiation, External Beam Radiotherapy, Definitive Radiation Therapy, EBRT, External Beam RT
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Therapeutic radiology procedure (C1522449)

Definition (MEDLINEPLUS)

Radiation therapy is a cancer treatment. It uses high doses of radiation to kill cancer cells and stop them from spreading. About half of all cancer patients receive it. The radiation may be external, from special machines, or internal, from radioactive substances that a doctor places inside your body. The type of radiation therapy you receive depends on many factors, including

  • The type of cancer
  • The size of the cancer
  • The cancer's location in the body
  • How close the cancer is to normal tissues that are sensitive to radiation
  • How far into the body the radiation needs to travel
  • Your general health and medical history
  • Whether you will have other types of cancer treatment
  • Other factors, such as your age and other medical conditions

Radiation therapy can damage normal cells as well as cancer cells. Treatment must be carefully planned to minimize side effects. Common side effects include skin changes and fatigue. Other side effects depend on the part of your body being treated.

Sometimes radiation is used with other treatments, like surgery or chemotherapy.

NIH: National Cancer Institute
Definition (NCI_NCI-GLOSS) The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body.
Definition (NCI_CDISC) Treatment of a disease by means of exposure of the target or the whole body to radiation.
Definition (NCI) Treatment of a disease by means of exposure of the target or the whole body to radiation. Radiation therapy is often used as part of curative therapy and occasionally as a component of palliative treatment for cancer. Other uses include total body irradiation prior to transplantation.
Definition (CSP) therapeutic use of ionizing and nonionizing radiation; for radioisotope therapy refer to RADIONUCLIDE THERAPY and narrower terms; for therapeutic radiation with visible, laser, or ultraviolet light, respectively refer to PHOTOTHERAPY, LASER THERAPY, or ULTRAVIOLET THERAPY and narrower terms.
Definition (MSH) The use of IONIZING RADIATION to treat malignant NEOPLASMS and some benign conditions.
Concepts Therapeutic or Preventive Procedure (T061)
MSH D011878
ICD10 U006287, D
SnomedCT 108290001, 302505005, 61757002, 182666000, 150903009, 53438000
CPT 1010843
LNC LA4351-8
English Radiotherapies, Radiotherapy, Radiation therapy, Radiation Oncology Procedures, Radiation, RT, RADIOTHER, radiation therapy, radiation therapy (treatment), irradiation, Radiotherapy NOS, Therapeutic radiology, radiation therapies, therapy radiation, radiations therapy, Irradiate, Irradiated, Radiation Therapy, Radiotherapy (regime/therapy), Radiation therapy (procedure), radiation therapy and/or radiation oncology, radiation therapy and/or radiation oncology (treatment), radiation therapy procedure or service (treatment), Radiation Therapy (Procedure), Radiation Oncology Treatment, irradiated, RADIATION, Radiation therapy procedure or service, RT - Radiotherapy, Radiotherapy procedures, Radiation oncology AND/OR radiotherapy (procedure), Radiation oncology AND/OR radiotherapy, Radiation therapy procedure or service (procedure), radiotherapy, therapy, radiation, Radiation therapy procedure or service, NOS, Radiation therapy, NOS, Radiotherapy, NOS, Irradiation, Cancer Radiotherapy, Radiotherapeutics, Therapy, Radiation, Therapeutic radiology procedure, Therapeutic radiology for cancer treatment
Dutch bestralingstherapie, radiotherapie NAO, radiotherapie, Radiotherapie
French Radiothérapie SAI, Radiothérapie
German Strahlentherapie NNB, Radiotherapie, Strahlentherapie
Italian Terapia con radiazioni, Radioterapia NAS, Radioterapia
Portuguese Radioterapia NE, Radioterapia
Spanish Terapia de radiación, Radioterapia NEOM, radioterapia, radioterapia (concepto no activo), terapia radiante, procedimiento o servicio de radioterapia (procedimiento), procedimiento o servicio de radioterapia, procedimiento o servicio de terapia radiante, radioncología Y/O radioterapia (procedimiento), radioncología Y/O radioterapia, radioncología Y/O terapia radiante, Radioterapia
Japanese 放射線療法ＮＯＳ, ﾎｳｼｬｾﾝﾘｮｳﾎｳNOS, ﾎｳｼｬｾﾝﾘｮｳﾎｳ, 放射線治療, 標的放射線療法, 放射線療法, ターゲット放射線療法
Swedish Strålbehandling
Czech radioterapie, Radioterapie, Radiační terapie, Radioterapie NOS
Finnish Sädehoito
Russian LUCHEVAIA TERAPIIA, РАДИОТЕРАПИЯ, RADIOTERAPIIA, ЛУЧЕВАЯ ТЕРАПИЯ
Croatian RADIOTERAPIJA
Polish Radioterapia, Radioterapia celowana
Hungarian Sugárkezelés k.m.n., Sugárkezelés, Radiotherapia
Norwegian Radioterapi, Strålebehandling, Stråleterapi
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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