Radiation therapy (synonym: radiotherapy, radiatio) of tumor patients is used depending on the exact type of tumor – with curative (curative) as well as palliative (disease-moderating) intent – if necessary in combination with surgery and/or chemotherapy.
In about 90 % of cases, a locoregional therapy, i.e. surgery and/or radiotherapy, is performed. However, the therapy also damages the adjacent healthy body cells, except that healthy body cells are more likely to regenerate. The body’s cells that divide frequently, such as the cells of the mucous membranes, the hematopoietic bone marrow, the immune system and the hair roots, are particularly sensitive.
In the therapy of metastases (daughter tumors) of radiation-sensitive primary tumors such as lymphomas, prostate or germ cell tumors, radiation therapy is of great importance [standard therapy: both for analgesia (abolition of pain sensation), recurrence prevention and recalcification/increased absorption of calcium into the bone].
According to a comparative study, stereotactic ablative radiation significantly prolongs progression-free survival (the time between the start of a clinical trial and the onset of disease progression or the patient’s date of death) in patients with oligometastases (few daughter tumors) compared with the control group receiving standard palliative therapy alone (medical treatment that does not aim to cure a disease but to relieve symptoms or reduce other adverse outcomes). With a median follow-up of 25 months in the control group and 26 months in the radiotherapy group, radiotherapy showed a 13-month longer survival.
Side effects of radiatio in most cases are:
- In oral, pharyngeal, and esophageal tumors (tumors of the esophagus), concomitant edema (water retention) and mucosal inflammation (stomatitis, esophagitis) lead to dysphagia (dysphagia) and odynophagia (If GERD is assumed and no alarm symptoms are present, empiric therapy with proton pump inhibitors (PPIs) can be given. On the other hand, if alarm symptoms are present, such as dysphagia, odynophagia, recurrent vomiting, (involuntary) weight loss, anemia, evidence of GI blood loss, or a mass).
- Malabsorption (digestive disorder in which absorption of macronutrients (carbohydrates, fat, protein) and/or micronutrients (e.g., vitamins) through the intestine into the vascular system is impaired)
- Enteritis (inflammation of the small intestine)
- Colitis (inflammation of the large intestine)
- Motility disorders
- In abdominal radiatio: nausea (nausea), vomiting and diarrhea (diarrhea).
Tolerance to radiatio depends largely on the patient’s baseline physical fitness, general lifestyle, and attitude toward therapy.
