Guidelines for Complications of Cancer Treatment Vol VIII Part B

Complications of Abdomino-PelvicRadiotherapyIntroduction:Radiation therapy is an established treatment modality in themanagement of patients with gynecological, gastrointestinaland genitourinary malignancies. The radiation can be eitherexternal beam (teletherapy) alone, internal (brachytherapy)or combination. Radiation therapy (external alone orcombination of external and brachytherapy) is given indifferent settings depending on the intent of treatment. It couldbe in radical radiation, post or peri-operative adjuvant, salvageor palliative settings. In recent past there has been a paradigmshift towards use of concomitant chemoradiation forradiosensitization. The classical example to illustrate use ofradiation in various settings is cervical cancers. In stage II/IIIcervical cancers radical radiation therapy with / withoutconcomitant chemotherapy is the treatment of choice.Radiation is also given as adjuvant postoperative treatment inpatients with high risk histo-pathological features like, tumorsize, positive margins, lymphovascular invasion or positivelymph nodes in cervical and endometrial cancers after radicalsurgery and risk stratification . In cases where para aortic lymph263