Complications of radiotherapy for treatment of cervix cancer

1. Acute radiation morbidity occurs during or just after radiotherapy and can generally be managed symptomatically with good results. 2. Late radiation morbidity results from tissue hypoxemia and from parenchymal cell loss, which leads to fibrosis and may progress to necrosis and fistula. 3. Rectal injuries generally occur before bladder injuries. In either event, the interval between treatment and complication can be up to 30 years. 4. Irradiated patients may not have the usual signs and symptoms of peritonitis, making correct diagnosis of serious intra-abdominal events difficult. 5. A biopsy should never be performed in an irradiated field simply to confirm the clinical impression of radiation morbidity. 6. Anastomosis of any type performed for reasons of radiation morbidity should be between unirradiated tissue when at all possible.