Radiology in oncology consequences. Radiation therapy (radiotherapy) - what is it and what is its essence? Indications, types and methods of implementation. Use of Rhodiola rosea and Eleutherococcus

Some patients recover fairly quickly after radiation therapy with rest and a balanced diet. In another part of patients, after treatment, serious complications may arise, caused by general intoxication of the body and requiring medication.

Using lungwort

Use of Rhodiola rosea and Eleutherococcus

The use of adaptogen plants such as Rhodiola rosea and Eleutherococcus are very effective for the recovery of patients undergoing radiation therapy. The drugs weaken the toxic effects of radiation on the body and improve blood counts. Experts also point to the antitumor properties of these plants.

Using herbal teas

For the rehabilitation of patients who are severely weakened after a course of radiation therapy, herbalists recommend the use of special healing herbs.

Using bergenia and nettle

To improve the blood count, especially when platelets are low, herbalists recommend using preparations of bergenia root and nettle leaves.

Nutrition for cancer

What should the diet be like? oncological diseases? What foods are absolutely contraindicated for this or that form of cancer?

Herbal medicine in oncology

Herbal medicine can provide significant assistance not only in the treatment of cancer, but also in their prevention.

Heredity and cancer

Many people who have cancer in themselves or in their relatives are interested in the question: is cancer inherited?

Cancer during pregnancy

Treatment of cancer during pregnancy is quite difficult, because most medicines has toxicity.

Pregnancy after cancer

What are the prospects for pregnancy after cancer? Should you wait until after cancer treatment?

Cancer Prevention

Prevention is an important part common struggle with cancer. How to reduce the likelihood of cancer?

Palliative treatment of cancer

What is palliative cancer treatment? How can it affect the quality of life of a cancer patient and change it for the better?

New cancer treatments

Scientists have developed quite a lot of promising cancer treatment methods that have not yet been recognized official medicine. But everything can change!

Cancer statistics

Cancer incidence statistics, unfortunately, are disappointing: there is an increase in the number of cases, while the disease is getting younger.

About “folk” medicine

Sometimes it is possible to defeat cancer using “folk” methods, but there are many more of those who relied only on them and ended up leaving this world ahead of time.

How to fight cancer?

How to find strength to fight cancer? How not to fall into despair over possible disability? What can serve as hope and meaning in life?

How to help your loved ones?

How can you help a loved one live with a cancer diagnosis? Is a “white lie” necessary? How to behave so that loved ones suffer less?

Stress and cancer

There is an opinion that constant stressful situations can lead to the development of cancer. Is it so?

Fighting cachexia

Many cancer patients often suffer from sudden weight loss. What causes this and is there any way to deal with this problem?

Caring for bedridden patients

The rules for caring for patients who are forced to constantly remain in bed have their own characteristics and must be known.

Radiation therapy for the treatment of cancer, its consequences and types

One of the widely used and effective areas in oncology for the treatment of cancer is radiation therapy. Tumor cells are highly sensitive, the consequences are usually minimal, because healthy cells are not affected. The essence is exposure to special ionizing radiation created by modern equipment based on a radiation source.

What is

Radiation for oncology is most often resorted to after surgery to remove the tumor focus. This treatment method involves exposure to radionuclides, to which mutated cells remain highly susceptible. In this case, healthy tissue elements may also be damaged, however, in smaller quantities.

To minimize the consequences, irradiation is carried out in several sessions so that the body has time to adapt to the received doses of rays and recover.

In cells affected by atypia, the radioactive source forms an even greater number of mutations. The result is their death. The success of treatment is also facilitated by a special technique in which rays affect the tumor site from different directions, with a maximum dose concentration.

At the time of irradiation, the patient does not experience any intense pain. The procedure is carried out in a specially equipped room. Medical staff accompany cancer patients at all stages of treatment. With the help of protective blocks, damage to healthy areas of the body is prevented.

The duration of the session is only 1–5 minutes, supervision of a specialist is strictly necessary. As a rule, the duration of external irradiation courses is at least a month. However, there are other methods - with a rapid increase in radiation doses, the time is reduced several times.

Basic methods

The focus of atypical cells is eliminated when the maximum dose of ionizing radiation accumulates in it. To achieve a similar result, various techniques are currently used in which rays are directed to the cancer site from different directions:

irradiation is performed from a certain distance from the surface of the patient’s skin - remote method;
if the equipment is placed directly on the body of a cancer patient - contact method;
if the device is inserted by a specialist into an organ affected by a tumor process - intracavitary method;
when placing a source of radioactive rays into the tumor tissue itself - the interstitial method;
with direct penetration of radionuclides into the source - internal irradiation.

Typically, radiation therapy malignant tumors- just one of the directions complex therapy, along with chemotherapy and surgical excision of the lesion. Radiation exposure is used:

in order to reduce the size of the tumor - before surgery;
to destroy the remaining mutated cells - after the main surgical excision;
combination therapy – both before and after surgery;
Possible use for relapse of pathology;
in case of tumor metastasis to bone and lymphatic structures.

The optimal methods of cancer treatment are selected by a specialist in each case individually - based on the diagnosed pathology, severity of symptoms, and age category of the patient.

Main contraindications

Like any medical treatment, radiation therapy for cancer has its own list of contraindications. Among the main limitations to such therapy are:

pronounced manifestations of intoxication;
severe general condition of the cancer patient;
febrile processes in the body;
cachexia;
stage of disintegration of the tumor focus - hemoptysis and various bleeding are already observed;
extensive damage by cancerous foci, many metastases;
germination malignant neoplasm in large vessels, as well as hollow organs;
pleurisy of a tumor nature;
developed radiation sickness;
concomitant somatic pathologies in the stage of decompensation, for example, previous myocardial infarction, or inspiratory failure, cardiovascular system, diabetes;
failures in hematopoietic organs– severe anemia, leukopenia.

A thorough assessment of all information received by a specialist at the stage of preparation for treatment from diagnostic examinations, which helps to identify such contraindications. In this case, the oncologist selects other treatment methods.

Radiation therapy: pros and cons

What is radiation therapy for oncology, its advantages and possible disadvantages– all these issues are discussed in detail by the treating specialist during a preliminary consultation.

Among the undoubtedly positive points we can point out:

atypical cells stop dividing randomly, the tumor focus is significantly reduced;
the vascular structures feeding the malignant neoplasm become overgrown;
Radioactive therapy in the treatment of cancer is effective against many forms of cancer pathology.

However, there are also some disadvantages:

hypersensitivity to radionuclides of elements of the hematopoietic system, as well as the epithelium of intestinal loops;
low sensitivity to rays of tumor foci in the area of the kidneys, brain, stomach, bone structures;
A certain percentage of cancer patients develop severe complications.

That is why it is so important to preparatory stage carry out all possible diagnostic procedures– to have a complete picture of the patient’s initial health status and his possible perception of future radiation therapy.

Possible side effects

When treating cancer, it is currently impossible to completely avoid the occurrence of undesirable effects from radiation therapy administered to a cancer patient. The specialist initially evaluates the possible benefits of this treatment method and the possible negative consequences for the body.

The latter usually include:

with the remote technique - intense itching, peeling of the dermis, as well as hyperemia and small blisters;
with radiation exposure to the head and neck area - alopecia, focal or diffuse, deterioration of hearing parameters;
intense sore throat, pain when eating, and hoarseness are possible;
when an area is irradiated chest– the appearance of unproductive coughing activity, increasing shortness of breath, painful impulses in muscle groups;
when exposed to the mammary glands - inflammatory lesions on the skin, moderate tissue discomfort, coughing;
radioactive therapy on the structures of the gastrointestinal tract leads to significant weight loss, loss of appetite, dyspeptic various disorders- urge to nausea, vomiting, gastralgia.

The recommendations of oncologists given to patients at the stage of preparation for radiation therapy help to minimize the above-described negative effects. Oncology is not a pathology that you can cope with on your own. Self-medication is absolutely prohibited.

Intraoperative contact and conformal therapy

It is a technique in which radiation is applied to the bed of deep-seated malignant neoplasms immediately after surgery to remove them. For example, with tumors affecting the esophagus, mammary glands, and colorectal area.

Experts indicate that the main advantages are that ionizing flows are directed directly to the cancer site, while healthy tissues are not subject to negative processes.

Conformal radiation therapy is an innovative technique for combating tumors at a distance. It is based on the principle of selectivity - using a three-dimensional coordinate system and computer irradiation planning.

Tissues with atypia receive the most destructive dose of radiation for them, and the surrounding areas are practically not affected. It has proven itself excellent in identifying prostate tumors.

The procedure is well tolerated even by elderly patients, as well as those with concomitant somatic pathologies. The main condition for the success of such therapy is the absence of malignant growth in the rectal area or Bladder.

The advantages of the technique include low trauma, absolute painlessness, as well as the possibility of being carried out in an outpatient setting and the absence of the need for rehabilitation. There are no age restrictions, as well as typical radiation complications.

Palliative radiotherapy

In case of severe oncological process, at the stage of realizing that the ongoing therapeutic measures turned out to be ineffective, to alleviate negative symptoms and improve the patient’s quality of life, they resort to palliative therapy.

Its goal is to help a person fight a pain syndrome, with progressive insufficiency internal organs, as well as alleviate psychological distress.

Palliative radiation therapy is aimed only at metastatic lesions. It slows down their growth rate. The technique is also popular when localizing a tumor focus in hard-to-reach, inoperable areas of the body.

With its help, the patient has the opportunity to minimize the manifestations of respiratory failure due to cancerous lesions of the pulmonary structures, and to delay intestinal obstruction.

Rehabilitation period after radiation therapy

Following the following recommendations from oncologists helps to minimize the impact of radiation exposure, as well as help the body quickly cope with its negative consequences:

after each procedure, rest for at least 3.5–5 hours;
adjust the diet - food should be fortified, easily digestible, fractional, most dishes from vegetables and fruits;
maintain a drinking regime - to fully remove toxins, the volume of liquid per day is at least 2–2.5 liters;
purchase underwear only from natural, breathable and hygroscopic fabrics - optimally from natural cotton, linen;
carry out hygienic procedures every day, with heated liquid and a mild soap solution, without washcloths and sponges;
throughout the entire treatment period, avoid perfume products, and protect the area of direct exposure from sunlight as much as possible;
perform breathing exercises daily to saturate tissues and organs with oxygen molecules;
buy gel toothpaste, use gentle toothbrush, and also limit the use of dental prostheses;
spend more time outdoors - leisurely walks through the forest park for at least 2.5–4 hours every morning and evening;
give up existing negative habits - consumption of tobacco and alcohol products.

The best set of rehabilitation measures will be recommended by a specialist for each patient individually.

The following parameters are taken into account: the oncological disease diagnosed in a person, the total number of courses of radiation therapy, age category, burden of somatic pathologies. However, in most cases rehabilitation period It does not take much time, the patient returns to his daily life.

My father was prescribed radiation therapy because oncologist surgeons refused to perform the operation due to heart problems. That is, not after the operation, but instead of it. The tumor, of course, did not disappear, but the rate of its growth and development decreased significantly.

My mother was prescribed radiation therapy after chemotherapy. it is necessary to complete the full course of treatment.

My mother had her breast removed and was given radiation therapy to avoid the risk. We scheduled 5 sessions, each every other day. The main side effects were fear of getting a burn to the esophagus. Mom took eggnog and dissolved sea buckthorn oil one spoon at a time. That's how they did everything in the department. There was no burn to the esophagus, but my voice was hoarse for a while.

My father-in-law was given radiation therapy simply to alleviate his condition. He had lung cancer, he could not breathe due to the growing tumor. Any treatment was useless, because... discovered late. But something had to be done and we chose this method. After radiation he felt much better.

I am still confident that a way to completely cure cancer at any stage will soon be found.

may God hear you

I encountered radiation therapy when my grandmother had it. The effect is certainly noticeable; the tumor has stopped growing. But to be honest, I was very worried; I had heard little about this method at that time.

Described methods of diagnosis, treatment, recipes traditional medicine etc. It is not recommended to use it on your own. Be sure to consult a specialist so as not to harm your health!

Radiation for oncology, or radiation therapy, is used for the purpose of harmful effects ionizing radiation on cancer cells. As a result, malignant tumors are destroyed at the molecular level. This method therapy has proven effectiveness and is widely used in medicine. However, the use of radiation in oncology has a number of negative consequences, which can manifest themselves both at the beginning of therapy and after long time after her.

Radiation for oncology: consequences

Description of the method

Radiation, or radiotherapy, is used to eliminate tumor formations of malignant and benign origin, as well as to treat non-tumor diseases when other therapy is ineffective. Most cancer patients with different types Radiation is indicated for cancer. It can be carried out as an independent method of treatment or combined with other methods: surgery, chemotherapy, hormone therapy, etc.

The goal of radiation therapy is the penetration of ionizing radiation into the pathological formation and having a destructive effect on it. The effect of therapy is due to high radiosensitivity cancer cells. When exposed to radiation, trophic processes and reproductive function are disrupted at the molecular level. This determines main effect radiotherapy, since the main danger of cancer cells lies in their active division, growth and spread. After some time, pathological tissues are destroyed without the possibility of restoration. Formations that are particularly sensitive to radiation include lymphomas, seminomas, leukemia, and myelomas.

Reference! During radiotherapy, the negative effects of radiation also extend to healthy cells, but their susceptibility to it is much lower than that of cancer cells. At the same time, the ability to recover in normal tissue is quite high compared to pathological lesions. Therefore, the benefits of the treatment prevail over its possible consequences.

Radiation therapy does not cause organic and functional disorders in organs, is a leading method in the treatment of cancer. It quickly eliminates the symptoms of the disease and increases survival rates. In palliative treatment, it improves the quality of life of seriously ill patients, softening clinical picture diseases.

Indications for radiation therapy

Attention! The age and size of the tumor directly affect the effectiveness of the radiation given. The younger the formation, the easier it is to treat. Therefore in this case great importance has timely access to a doctor.

Classification of radiation therapy

With the development of medical technologies, radiotherapy methods are being improved that can significantly reduce the negative consequences of treatment and increase its effectiveness. Based on the source of ionization radiation, there are the following types irradiation:

alpha, beta, gamma therapy. These types of radiation differ in the degree of penetration;
X-ray therapy – it is based on X-ray radiation;
neutron therapy – carried out using neutrons;
proton therapy – based on the use of proton radiation;
Pi-meson therapy is a new radiotherapy technique that uses nuclear particles produced by specialized equipment.

Types of radiation therapy

Based on the type of radiation exposure to a person, radiotherapy for oncology can be:

external (external) - focused ionized beams enter through skin using a linear accelerator of charged particles. Usually the doctor determines a specific area for exposure, in some cases general body irradiation is prescribed;

internal (brachytherapy) - a radioactive substance is placed inside the formation or nearby tissue, neutralizing pathological cells. This method is effective for oncology of the female reproductive organs, breast, prostate glands. Its advantages lie in the precise impact on education from the inside, while the negative consequences of treatment are practically absent.

Principles of radiotherapy

The choice of method is made by the oncologist, based on the location of the tumor. He also develops an individual treatment regimen to obtain maximum results from radiation. In this case, the following types of treatment are available:

in certain situations, radiation therapy completely replaces surgical procedures;

adjuvant treatment - in this case, radiation is applied after surgical intervention. This regimen for breast cancer is not only effective, but also organ-saving;
induction therapy (neoadjuvant) - the use of radiation before surgery. Facilitates and increases the efficiency of surgical intervention;
Combination therapy – radiation is combined with chemotherapy. After this, surgery is performed. Combining the three methods allows you to achieve maximum efficiency and reduce the volume of surgical procedures.

Radiation therapy for malignant tumors

Important! Sometimes combining chemotherapy and radiation is enough to cure and surgery is not required (cancer of the lung, uterus or cervix).

To avoid the negative consequences of radiotherapy as much as possible, it is carried out in a targeted manner, avoiding damage to healthy tissue. For this purpose, in the process of preparing for radiotherapy, they use various ways visualization of education and surrounding space.

This causes a direct effect of radiation on the pathological focus, protecting healthy cells. The following methods are used for this:

intensity modulated radiotherapy (IMRT) – modern technique promotes the use of radiation doses higher than with conventional radiation;
Image-guided radiotherapy (IRT) is effective when used on mobile organs, as well as on formations close to organs and tissues. When combined with IMRT, it delivers the radiation dose as accurately as possible not only to the pathological focus, but also to its individual areas;
Stereotactic radiosurgery – precise delivery of radiation doses through three-dimensional visualization. This gives clear coordinates of the formation, after which the rays target it. Known as the Gamma Knife method.

Types of Radiation Therapy

Radiation dose

The negative consequences of radiation directly depend on the dose of ionizing radiation entering the human body. Therefore, at the stage of preparation for therapy, accurate dose calculation is important. When determining an individual treatment plan, a variety of factors are assessed:

size and type of education;
precise placement;
the patient’s condition based on the results of additional studies;
presence of chronic diseases;
previous irradiations.

Examinations before radiation therapy

Taking into account the indicators, medical specialists determine the total dose of radiation for the full course and for each session, their duration and number, breaks between them, etc. A properly calculated dose helps achieve maximum treatment effectiveness with minimal presence of undesirable effects. side effects.

Consequences of radiation in oncology

Tolerance to radiation therapy varies greatly among patients. Some patients experience side effects exclusively during the period of treatment, in others the consequences develop some time after it. It happens that negative phenomena are completely absent.

Radiation reactions and damage

Typically, the severity of side effects depends on the duration of radiation and its dose. The location of the cancer, its stage, the patient’s condition, and individual tolerance to the procedure also have an impact.

The general effects of radiotherapy are presented in the following table.

The most common negative effect of radiation is hypersensitivity reactions on the skin, similar to a burn. They usually appear two weeks after the start of therapy and heal a month after the cessation of radiation exposure. There are three degrees of damage to the epidermis:

the first is slight redness;
the second – redness, peeling, possible swelling;
third – significant redness with weeping peeling, severe swelling.

Attention! When a radiation wound becomes infected, symptoms intensify, swelling and redness increase, an unpleasant odor appears from the affected area, and a high temperature is possible.

Consequences for respiratory system occur during chest irradiation and usually appear within three months after therapy. Violations in circulatory system occur when a large area of the body is exposed to radiation.

A common side effect of radiation therapy is fatigue. General weakness persists for a long time and does not go away after sleep and rest. In some cases it is a consequence of anemia.

Long-term consequences of radiotherapy include:

fibrosis (replacement of affected connective tissue);
dry skin and mucous membranes (eyes, mouth);
oncology (development of secondary formations);
skin pigmentation;
hair loss;
death (with concomitant cardiovascular pathology);
decreased cognitive function.

Local radiation reactions

The occurrence of serious consequences is quite rare and is associated with prolonged exposure to ionizing radiation on the body or concomitant diseases. Usually the manifestations are moderate and disappear over time. The benefits of the treatment significantly outweigh the risk of undesirable consequences.

Video - About radiation therapy

Video - Commentary on patient radiation therapy

Video - Radiation therapy: consequences and what helps with burns

During and after treatment, the body needs help to rehabilitate. The oncologist prescribes a set of drugs and measures to stabilize the patient’s condition and restore the body’s strength.

For minor skin reactions, hygiene and moisturizing the damaged area with cream is recommended. For severe lesions, hormonal ointment is used. Radiation wounds serve as “entry gates” for infection, so antiseptic treatment with a bandage should be carried out regularly. Clothing should be comfortable and loose, and avoid rubbing the affected areas.

Don't forget about healthy life. It is necessary to observe the daily routine, work and rest, and perform all possible physical exercise, take walks in the fresh air, gradually increasing the distance.

Recovery after radiation therapy

Nutrition is of great importance; your doctor can recommend a list of foods you want to eat.

Important! During radiation therapy and during the recovery period, you cannot follow a diet!

The menu should be high in calories and high in protein. At the same time, fried, fatty, smoked foods, and alcohol are excluded. It is advisable to include foods rich in vitamins, antioxidants, and plant fiber in your diet. In case of nausea and vomiting, antiemetic drugs are prescribed, in some cases they are taken some time before the start of treatment. Recommended consumption a large number of liquids, about three liters per day. This helps eliminate intoxication and restore the body.

To get rid of the effects of radiation, physiotherapy (electric and phonophoresis, magnetic therapy) is used; inhalations and special gymnastics are used for respiratory disorders. For improvement general condition, getting rid of chronic fatigue massage sessions are scheduled.

Radiation therapy: types of treatment, side effects, patient rehabilitation

One of the ways to treat cancer is radiation therapy. It has been revealed that young, malignant cells stop multiplying under the influence of radioactive radiation.

Concept

Radiation therapy involves exposure to ionized radiation. His goals:

damage to malignant cells,
limiting cancer growth,
prevention of metastasis.

Used in combination with surgical treatment and chemotherapy.

The effect is enhanced due to the fact that the doctor can adjust the direction of the rays. This makes it possible to use maximum doses at the lesion site.

Sometimes this method is also used to treat non-oncological pathologies. For example, to combat bone growths.

Video about pre-radiation preparation:

Indications

The method is used in 60-70% of patients with cancer. It is considered fundamental for the treatment of tumors that differ high degree radiosensitivity, rapid progression, as well as with some features of the localization of the formation.

Radiation therapy is indicated for cancer:

Types of radiation therapy

There are several treatment methods. Alpha radiation involves the use of isotopes, for example, radon, thoron products. This type has a wide range of applications, has a positive effect on the central nervous system, endocrine system, heart.

Beta therapy is based on the healing effect based on the action of beta particles. Various radioactive isotopes are used. The decay of the latter is accompanied by the emission of particles. There is such therapy as interstitial, intracavitary, or application.

X-ray therapy is effective for the treatment of superficial lesions of the skin and mucous membranes. The X-ray energy is selected depending on the location of the pathological focus.

Radiation therapy is also divided for other reasons.

Contact

This type differs from the others in that the ray sources are located directly on the tumor. It is characterized by a dose distribution so that the main part remains in the tumor.

The method is good if the size of the formation is no more than 2 cm. This type is divided into several types.

Remote

It implies that the source of radiation is located at some distance from the human body. the beam enters the body through a certain area.

Gamma therapy is most often used. This method is good because it allows a high dose of radiation to be applied to the formation, while keeping healthy cells intact.

For small cancers, protons and neurons are used. Remote therapy can be static or mobile. In the first case, the radiation source is stationary.

In modern oncology clinics the method is rarely used. The moving technique allows you to direct the source along different trajectories. This provides the greatest efficiency.

Radionuclide

The specificity lies in the introduction of radiopharmaceuticals into the patient’s body. They affect the lesions. Targeted delivery of substances creates very high doses with few side effects and minimal damage to healthy tissue.

Radioiodine therapy is popular. The method is used not only for cancer patients, but also for the treatment of people with thyrotoxicosis. If there are bone metastases, then several compounds are used at once.

Conformal

Radiation exposure where three-dimensional exposure planning is used to obtain the field shape. The method allows adequate doses of radiation to be delivered to tumors. This significantly increases the chance of cure.

To prevent the tumor from leaving the irradiated area, special devices are used, for example, equipment for active breathing control.

Proton

Radiation therapy based on the use of protons, which are accelerated to high values. This allows for a unique dose distribution over depth, with the maximum dose concentrated at the end of the run.

At the same time, the load on other surface cells is minimal. The radiation is not scattered throughout the patient's body.

Typically, the method is used for small formations, tumors located close to critically radiosensitive structures.

Intracavity

This species has several types. Allows for the prevention of relapses and metastasis. The source is inserted into the body cavity and remains present throughout the entire irradiation session.

Used to create maximum dose in tumor tissues.

Usually this method is combined with remote. This type of radiation therapy is used to treat cancers of the female genital area, rectum and esophagus.

Stereotactic

This method can reduce cancer treatment time.

Used to treat tumors of the brain, internal organs, and circulatory system. The rays act very precisely on the tumor.

Photo of stereotactic radiation therapy

It is carried out with full control over the location of the tumor, allowing you to adapt to the patient’s breathing and any other movement.

The result of this effect is not visible immediately, but after several weeks, since the tumor cells die gradually.

Contraindications

There are several situations when radiation therapy is contraindicated:

general serious condition with signs of intoxication of the body,
fever,
cachexia,
extensive damage by cancer cells, accompanied by bleeding,
radiation sickness,
severe forms of concomitant diseases,
severe anemia.

The limitation is a sharp decline in the blood of leukocytes or platelets.

How is radiation therapy performed?

First, additional procedures are carried out to accurately determine the location of the tumor and its size. From this the dose is selected. Using a special apparatus, the irradiation field is determined. There may be several such areas.

During radiation treatment, the patient is in a lying position. It is important not to move during radiation, as this may cause the rays to damage healthy tissue. If a person cannot remain still for a long time, the doctor immobilizes the patient or area of the body.

Some machine parts may move and make noise; do not be alarmed. Already at the beginning of treatment, it is possible to reduce pain, but the greatest effect is achieved after completion of the course.

Course duration

Treatment is often carried out on an outpatient basis. The session, depending on the method used, lasts minutes.

Most of the time is spent positioning the patient correctly and guiding the radiation device. The process itself lasts several minutes. Staff will leave the premises during this time.

How is the procedure tolerated?

Radiation therapy itself does not cause painful sensations. After the procedure, it is recommended to rest for several hours. This will help restore strength and also reduce the risk of side effects.

If your throat or mouth has been exposed to irradiation, then it is recommended to rinse your mouth with herbal decoctions or sea buckthorn oil to relieve discomfort.

Symptoms after irradiation

After a course of radiation therapy, you may experience:

fatigue,
mood and sleep disturbances,
reactions from the skin and mucous membranes.

If the impact was carried out on the chest area, shortness of breath, difficulty breathing, and cough appear.

Consequences

The skin is most often affected. She becomes tender and sensitive. May change color.

The skin's reaction to radiation is approximately the same as with a sunburn, but it develops gradually.

Blistering may occur. If not properly cared for, such areas can become infected.

If the respiratory system was exposed, radiation damage develops over the next three months. Appears nonproductive cough, body temperature rises, and general health deteriorates.

Experts note that often side effects include:

hair loss,
decreased hearing and vision,
increase in the number of heartbeats,
change in blood composition.

Recovery after radiation

The recovery process can take different times, doctors recommend setting yourself up for a long journey.

Treatment of burns

Redness usually appears immediately, but for some people, burns do not begin to be detected immediately. After each session, it should be lubricated with a protective cream.

However, this should not be done before the procedure, as this may reduce the effectiveness of the manipulation. For treatment, D-Panthenol and other drugs are used to relieve inflammation and restore the dermis.

How to raise leukocytes after radiotherapy?

You can increase the number of leukocytes only after permission from your doctor. Be sure to diversify your menu with raw vegetables, buckwheat, fresh fruits, and rolled oats.

Pomegranate and beet juice have a positive effect on blood composition. If these methods do not help, the doctor will prescribe special medications.

What to do if you have a fever?

Fever is a sign of infection in most cases. After radiation therapy, it takes a long time for the immune system to recover.

It is better to immediately consult a doctor who will help identify the cause and prescribe treatment. If this is not possible, stay in bed and use antipyretics that are not contraindicated for your illness.

Pneumonitis

They are treated using high doses of steroids. Then the symptoms disappear within hours. The dose is reduced gradually.

Additionally used breathing exercises, massage, inhalation and electrophoresis.

The treatment program is drawn up individually, taking into account the type of tumor, its prevalence, and the presence of other complications.

Haemorrhoids

For treatment, it is necessary to strictly follow a diet and bed rest, use medications and traditional medicine. Radiation leads to disruption of epithelial maturation, inflammatory processes on mucous membranes.

Used for treatment local therapy, which allows you to cleanse the intestines and eliminate inflammatory processes.

Proctitis

To eliminate the problem, laxatives and cleansing enemas are used. Warm showers aimed at the rectal area and baths with potassium permanganate showed high effectiveness.

The doctor may prescribe hormones rectal suppositories and anesthetics.

Diet food

Adequate nutrition is one of the main methods of treating radiation damage. soft foods must be taken. If the oral cavity has been damaged by irradiation, then it is effective to use oil or novocaine solution.

During radiation therapy itself, patients usually complain of a lack of appetite. At this time, add nuts, honey, eggs, and whipped cream to the menu. They contain a lot nutrients. To obtain protein, puree soups, low-fat fish and meat broths are added to the diet.

The consumption of foods containing large amounts of cholesterol, fatty meat, mushrooms, tangerines, and sausage is contraindicated.

Answers on questions

How is chemotherapy different from radiation therapy?

Chemotherapy is the treatment of cancer using drugs. Radiation therapy is based on the principle of destruction of cells under the influence of rays.

World standards provide for a combination of these two methods, since the chance of cure in this case increases.

After radiation exposure, hair falls out only in the area where the rays pass. Doctors usually warn about the possibility of baldness. In this case, it is best to have a short haircut.

When caring for your hair from the moment you start treatment, use a wide-tooth comb or buy a baby comb. Before going to bed, use a special sleep net to prevent your hair from being pressed or pulled.

Many treatment methods leave a negative mark and affect reproductive functions. After radiation therapy, it is recommended to use contraception for several years.

This will allow the body to recover, give birth healthy child. The period is usually told by the oncologist depending on the stage of the cancer and the results of treatment.

One of the main problems of cancer tumors is uncontrolled cell division and proliferation. Radiation therapy in oncology and radiology can reduce aggressiveness, reduce tumor growth and force some cells to stop dividing. The most common forms of cancer cells are very sensitive to this effect.

Purposes of ionized radiation

Reducing the risk of metastases.
Reduce the growth rate of cancer tissue.
Lethal damage to tumor cells.

The impact is carried out using a linear accelerator on DNA molecules, which, under the influence of a dose of radiation, change and stop dividing. At the same time, healthy cells are not so susceptible to the effects, but young immature tumor cells, on the contrary, are very sensitive. But radiation for oncology is used only in combination with the main types of therapy: surgical treatment and chemotherapy.

IN Lately Radiation therapy began to be used for simple diseases, for example, in the fight against bone growths. The advantage of this treatment is that radio irradiation can be carried out in a targeted manner so as not to affect healthy cells.

When to use

As practice shows, radiotherapy is used for almost all oncological diseases - 55-75% of cases. Otherwise, cancer cells are not so sensitive to radiation, or the patient, on the contrary, has side effects and diseases for which this treatment is contraindicated.

We advise women and girls who have undergone radiation not to plan to give birth in the next couple of years, since the rays have a very strong effect on reproductive function. And to give birth to a healthy baby, you should wait a little - if you have time.

How much does radiotherapy cost?

In regular clinics and city hospitals they will give it to you for free. If you want to do it on more advanced equipment, then you should enroll in a paid hospital. In this case, the cost will vary from 15,000 to 50,000 rubles per procedure. Prices abroad are 2-3 times more expensive.

Is radiation therapy. It has been revealed that young, malignant cells stop multiplying under the influence of radioactive radiation.

Concept

Radiation therapy involves exposure to ionized radiation. His goals:

damage to malignant cells,
limiting cancer growth,
prevention of metastasis.

Used in combination with surgical treatment and chemotherapy.

During radiation exposure, cells do not disintegrate, but their DNA changes. The advantage of the method is that healthy structures do not undergo any changes.

The effect is enhanced due to the fact that the doctor can adjust the direction of the rays. This makes it possible to use maximum doses at the lesion site.

Sometimes this method is also used to treat non-oncological pathologies. For example, to combat bone growths.

Video about pre-radiation preparation:

Indications

The method is used in 60-70% of patients with cancer. It is considered the main treatment for tumors that are characterized by a high degree of radiosensitivity, rapid progression, and also with certain features of the localization of the formation.

Radiation therapy is indicated for cancer:

nasopharynx and rings of pharyngeal tonsils,
cervix,
larynx,
skin, breast,
lung,
language,
body of the uterus,
some other organs.

Types of radiation therapy

There are several treatment methods. Alpha radiation involves the use of isotopes, for example, radon, thoron products. This type has a wide range of applications; it has a positive effect on the central nervous system, endocrine system, and heart.

X-ray therapy is effective for the treatment of superficial lesions of the skin and mucous membranes. The X-ray energy is selected depending on the location of the pathological focus.

Radiation therapy is also divided for other reasons.

Contact

This type differs from the others in that the ray sources are located directly on the tumor. It is characterized by a dose distribution so that the main part remains in the tumor.

The method is good if the size of the formation is no more than 2 cm. This type is divided into several types.

Name	Peculiarities
Close focus	Irradiation affects the cells themselves.
Intracavity	The radiation source is introduced into the body cavities. It remains throughout the course of contact radiotherapy.
Interstitial	The radiation source is injected into the tumor. The impact occurs continuously.
Radiosurgery	The effects of rays occur after surgical operation. The area where the tumor was located is exposed to radiation.
Appliqué	The radiation source is applied to the skin using a special applicator.
Selective accumulation of isotopes	Low-toxic radioactive substances are used.

Remote

It implies that the source of radiation is located at some distance from the human body. the beam enters the body through a certain area.

Gamma therapy is most often used. This method is good because it allows a high dose of radiation to be applied to the formation, while keeping healthy cells intact.

For small cancers, protons and neurons are used. Remote therapy can be static or mobile. In the first case, the radiation source is stationary.

The method is rarely used in modern oncology clinics. The moving technique allows you to direct the source along different trajectories. This provides the greatest efficiency.

Radionuclide

The specificity lies in the introduction of radiopharmaceuticals into the patient’s body. They affect the lesions. Targeted delivery of substances forms very high doses in the lesions with few side effects and minimal impact on healthy tissue.

Conformal

To prevent the tumor from leaving the irradiated area, special devices are used, for example, equipment for active breathing control.

Proton

Radiation therapy based on the use of protons, which are accelerated to high values. This allows for a unique dose distribution over depth, with the maximum dose concentrated at the end of the run.

At the same time, the load on other surface cells is minimal. The radiation is not scattered throughout the patient's body.

Typically, the method is used for small formations, tumors located close to critically radiosensitive structures.

Intracavity

This species has several types. Allows for the prevention of relapses and metastasis. The source is inserted into the body cavity and remains present throughout the entire irradiation session.

Used to create the maximum dose in tumor tissues.

Usually this method is combined with remote. This type of radiation therapy is used to treat cancers of the female genital area, rectum and esophagus.

Stereotactic

This method can reduce cancer treatment time.

Used to treat internal organs and the circulatory system. The rays act very precisely on the tumor.

Photo of stereotactic radiation therapy

It is carried out with full control over the location of the tumor, allowing you to adapt to the patient’s breathing and any other movement.

The result of this effect is not visible immediately, but after several weeks, since the tumor cells die gradually.

Contraindications

There are several situations when radiation therapy is contraindicated:

general serious condition with signs of intoxication of the body,
fever,
extensive damage by cancer cells, accompanied by bleeding,
radiation sickness,
severe forms of concomitant diseases,
severe anemia.

A sharp decrease in leukocytes or platelets in the blood is also a limitation.

How is radiation therapy performed?

Course duration

Treatment is often carried out on an outpatient basis. The session, depending on the method used, lasts 15-45 minutes.

Most of the time is spent positioning the patient correctly and guiding the radiation device. The process itself lasts several minutes. Staff will leave the premises during this time.

The course lasts from 4 to 7 weeks. in some situations it is reduced to 14 days. This is advisable if it is necessary to reduce the size of the tumor or improve the patient's condition. Sessions are held 5 times a week. Sometimes the dose is divided into 2-3 sessions.

How is the procedure tolerated?

Radiation therapy itself does not cause pain. After the procedure, it is recommended to rest for several hours. This will help restore strength and also reduce the risk of side effects.

If your throat or mouth has been irradiated, then it is recommended to rinse your mouth with herbal decoctions or sea buckthorn oil to relieve discomfort.

Symptoms after irradiation

After a course of radiation therapy, you may experience:

fatigue,
mood and sleep disturbances,
reactions from the skin and mucous membranes.

If the impact was carried out on the chest area, shortness of breath, difficulty breathing, and cough appear.

Consequences

The skin is most often affected. She becomes tender and sensitive. May change color.

The skin's reaction to radiation is approximately the same as with a sunburn, but it develops gradually.

Blistering may occur. If not properly cared for, such areas can become infected.

If the respiratory system was exposed, radiation damage develops over the next three months. An unproductive cough appears, body temperature rises, and general health deteriorates.

Experts note that often side effects include:

hair loss,
decreased hearing and vision,
increase in the number of heartbeats,
change in blood composition.

Recovery after radiation

The recovery process can take different times, doctors recommend setting yourself up for a long journey.

Treatment of burns

Redness usually appears immediately, but for some people, burns do not begin to be detected immediately. After each session, it should be lubricated with a protective cream.

How to raise leukocytes after radiotherapy?

You can increase the number of leukocytes only after permission from your doctor. Be sure to diversify your menu with raw vegetables, buckwheat, fresh fruits, and rolled oats.

Pomegranate and beet juice have a positive effect on blood composition. If these methods do not help, the doctor will prescribe special medications.

What to do if you have a fever?

Fever is a sign of infection in most cases. After radiation therapy, it takes a long time for the immune system to recover.

Pneumonitis

They are treated using high doses of steroids. Then the symptoms disappear after 24-48 hours. The dose is reduced gradually.

Additionally, breathing exercises, massage, inhalations and electrophoresis are used.

The treatment program is drawn up individually, taking into account the type of tumor, its prevalence, and the presence of other complications.

Haemorrhoids

For treatment, it is necessary to strictly follow a diet and bed rest, use medications and traditional medicine. Radiation radiation leads to impaired maturation of the epithelium and inflammatory processes in the mucous membranes.

For treatment, local therapy is used to cleanse the intestines and eliminate inflammatory processes.

Proctitis

To eliminate the problem, laxatives and cleansing enemas are used. Warm showers aimed at the rectal area and baths with potassium permanganate showed high effectiveness.

The doctor may prescribe hormones, rectal suppositories and anesthetics.

Diet food

During radiation therapy itself, patients usually complain of a lack of appetite. At this time, add nuts, honey, eggs, and whipped cream to the menu. They contain many nutrients. To obtain protein, puree soups, low-fat fish and meat broths are added to the diet.

The consumption of foods containing large amounts of cholesterol, fatty meat, mushrooms, tangerines, and sausage is contraindicated.

Answers on questions

How is chemotherapy different from radiation therapy?

Chemotherapy is the treatment of cancer using drugs. Radiation therapy is based on the principle of destruction of cells under the influence of rays.

World standards provide for a combination of these two methods, since the chance of cure in this case increases.

Does hair fall out after radiation therapy?

After radiation exposure, hair falls out only in the area where the rays pass. Doctors usually warn about the possibility of baldness. In this case, it is best to have a short haircut.

Is it possible to get pregnant after radiation therapy?

Many treatment methods leave a negative mark and affect reproductive functions. After radiation therapy, it is recommended to use contraception for several years.

This will allow the body to recover and give birth to a healthy child. The period is usually told by the oncologist depending on the stage of the cancer and the results of treatment.

Radiation (radiation therapy, radiotherapy, radiation therapy) is the use of ionizing radiation (X-rays, gamma radiation, beta radiation, neutron radiation) to damage, destroy, kill cancer cells, and stop the growth and reproduction of new mutated cells. Radiation is a localized treatment that typically affects only the part of the body where the radiation was directed.

As mentioned above, after radiation, cancer cells are damaged, although radiation can affect healthy cells in the body in the same way. Based on this, cancer after radiation may be accompanied by some complications that arise as side effects (depending on the part of the body on which irradiation was performed; on the location of the malignant neoplasm).

What is radiation treatment for cancer?

Radiation is a method of treating cancer using high-energy radiation (specifically X-rays). The type of radiation, as well as its amount, must be carefully calculated before starting therapy (in such an amount that the radiation can damage abnormal cells) by the treating oncologist team. During the treatment of oncology, irradiation stops the division of cancer cells and, as a result, their number will decrease.

Benefits of Irradiation

As we already know, the goal of radiation therapy is to destroy mutated cells while minimizing damage to healthy cells. Also, radiation can be used to treat any type of cancer, in almost any part of the body. In some cases, irradiation can be carried out separately, but most often it is used in combination with other methods of fighting cancer.

Irradiation can be carried out both before and after surgical treatment(before - to reduce the size of the tumor, after - to stop the growth of cancer cells that could remain after surgical excision of the malignant neoplasm). It can also be performed during or after chemotherapy or hormone therapy in order to improve overall results.

Despite the fact that such treatment is sometimes called radical, radiation therapy is designed to provide a long-term effect for a person with cancer.

This palliative treatment is aimed at reducing the size of the tumor, reducing pain, and relieving other symptoms of cancer. In addition, palliative radiation therapy can prolong the life of a cancer patient.

Cancer after radiation – what to expect? Consequences and complications

As already mentioned, radiation can damage and destroy normal cells, and also cause some side effects as cancer cells break down. Most of these side effects are temporary, rarely severe and do not pose a particular threat to the general condition and life of the patient. Remember, your doctor will not advise you to undergo radiation if the risks and complications outweigh the benefits. Also, the attending physician is obliged to inform you if this treatment in your case may adversely affect your health and provoke certain consequences. You must receive all necessary information in writing.

If a female is exposed to radiation, she should under no circumstances be in position at the time of therapy, since radiation therapy can greatly harm the unborn child, especially in the first three months of pregnancy. The doctor is obliged to inform you in advance about all the pros and cons of this treatment, O possible consequences and complications that may arise after radiation exposure, and provide written information about this.

The topic of side effects and complications is one of the most important in medicine. “Do no harm” is the main commandment of a doctor’s work at all times. Modern concept might look like this: the risk of disability and death from treatment complications should not exceed similar risks from the disease.

There is no doubt that such a complex and dangerous type of treatment as radiation therapy, despite its high effectiveness in oncology, is fraught with high risks side effects.

Classic factors of radiosensitivity of cells and tissues.

proliferative activity of a cell or tissue
degree of differentiation
cell cycle phase
partial pressure of oxygen in tissues
functional tension or pathological processes in tissues

Bergonier and Tribondo's law— radiosensitivity of tissues and cells is directly proportional to proliferative activity and inversely proportional to the degree of differentiation.

Phases of the cell cycle.

Maximum radiosensitivity is observed during the mitosis phase, followed by the postsynthetic and presynthetic periods. Maximum radioresistance is observed in the interphase and synthetic period. Thus, the radiosensitivity of a tissue is determined by the pool of cells proliferating in it.

Factors of radiosensitivity also include the partial pressure of oxygen in the tissue, the state of functional tension or the presence of pathological processes.

Taking into account radiosensitivity factors, let's list the most radiosensitive cells and tissues, although some of them do not obey the above laws:

– bone marrow stem cells

- epithelium

- germinal epithelium

— lymphocytes

- lens of the eye

Long-term consequences of irradiation.

We must not forget that when exposed to irradiation, even in small doses, morphological and genetic changes are possible in biological systems. Long-term effects of radiation are divided into two types:

— deterministic effects

— stochastic effects

Deterministic effects– are characterized by the presence of a radiation dose threshold, below which they are not observed. Manifest in the form of obvious pathology (radiation sickness, burns, cataracts, leukopenia, infertility, etc.).

Stochastic (probabilistic, random) effects– there is no dose threshold for the occurrence of these effects. They have a long latent period (years). They are non-specific.

To date, two types of stochastic effects have been proven:

malignant transformation as a consequence of mutations in the genome of a somatic cell

2. inherited birth defects in offspring with mutations in the germ cell genome

Today the world scientific community has accepted no-threshold hypothesis biological effects of ionizing radiation. Based on this hypothesis, at any level of absorbed dose, there is theoretically always a possibility of biological consequences. As the dose increases, the likelihood of effects increases linearly with the dose absorbed.

In addition to the classical factors of radiosensitivity of cells and tissues, to understand the mechanisms of the biological action of ionizing radiation, it is necessary to outline the theory "The nature of the organization of cell populations in various tissues."

Based on the nature of the organization of the cell population, two types of tissues are distinguished:

Hierarchical fabrics. H-systems (hierarchial cell population). These are fast update systems.
Sequentially functional fabrics. F-systems (flexible cell lineage). Slow update systems.
Tissues incapable of cellular renewal

H-systems consist of a hierarchy of cells from stem to functional. That. these tissues contain a large pool of dividing cells. These include: Bone marrow, epithelial tissues, germinal epithelium.

F-systems consist of a homogeneous population of functionally competent cells that are predominantly in interphase. These systems include: vascular endothelium, fibroblasts, parenchyma cells of the liver, lungs, and kidneys.

In addition to the H- and F-systems, there are tissues that are incapable of cellular renewal in an adult body ( nerve tissue and muscular).

When tissues with different organizational and cellular structures are exposed to ionizing radiation, they react differently over time and morphologically. This knowledge makes it possible to predict the type, time and severity of possible radiation-induced pathological processes.

Thus, in H-systems, early or acute radiation reactions predominate, which are associated with stopping the division of the most poorly differentiated stem cells, which normally provide the processes of reparative tissue regeneration.

For F-systems, long-term biological consequences of irradiation are more typical, associated with microcirculation disorders, slow devastation of the parenchyma, and tissue fibrosis.

Tissues incapable of cellular renewal after irradiation at any dose are characterized by stochastic radiobiological effects.

Side effects of radiation therapy:

general (asthenic and intoxication syndrome, myelo- and immunosuppression)
local: radiation reactions and radiation damage.

The likelihood and severity of common side effects during radiation therapy depends on:

volume of irradiated tissues (spot, local, regional, subtotal, total irradiation)
irradiation zones (extremities, pelvis, mediastinum, abdominal cavity, celiac plexus, brain)
total absorbed dose.
general somatic condition of the patient

Radiation reactions- This reactive changes normal tissues under the influence of ionizing radiation, occurring during a course of radiation therapy and lasting no more than 100 days (3 months) after its completion, and being reversible.

The main mechanism of pathogenesis: temporary block of reparative regeneration.

Radiation reactions are characteristic of tissues with rapid renewal (H-systems: bone marrow, epithelial tissues). 100 days is the deadline for repairing sublethal genomic damage. Radiation reactions occur in 100% of cases during radiation therapy.

The main prominent example is radiation dermatitis. Clinical manifestations arise from the 10-15th session of radiation therapy. It is most pronounced in fold areas (neck, axillary areas, perineum). The skin of the abdomen is highly radiosensitive. Characterized by 4 degrees.

Another, no less clinically significant, manifestation of radiation reactions is radiation mucositis. It also has 4 degrees. Most pronounced during radiation therapy of oral tumors and abdominal cavity. Manifests itself in the form of radiation stomatitis and enteritis. Despite the temporary nature of these phenomena, they can be so pronounced that they require stopping or discontinuing treatment, as well as significant drug correction.

The epithelium of the rectum, bladder, esophagus and stomach has a lower proliferation rate than in the oral cavity or small intestine. In this connection, radiation reactions may be less pronounced.

The severity and likelihood of radiation reactions depend on the following factors::

irradiation zones
volume of irradiated tissues
total dose and fractionation regimen of radiation therapy
initial state of reparation processes

The task of the radiotherapist: when the 2-3 degree of radiation reaction is reached, stop treatment in order to preserve the reserve pool of stem cells (surviving cells of the basal layer that have gone into interphase), which will ensure further repair of the epithelium.

Diseases such as diabetes, systemic atherosclerosis, immunodeficiency states, long-term use of corticosteroid hormones and NSAIDs, the patient’s hypotrophic status, decompensation of any somatic pathology, numerous courses of chemotherapy significantly disrupt reparative processes in tissues.

That. The role of therapeutic specialties related to oncology is enormous in terms of preparing the patient for radiation therapy, as well as in the post-radiation period. Objectives: correction and compensation of somatic pathology (diabetes mellitus, broncho-obstructive pulmonary diseases, systemic atherosclerosis, coronary artery disease, circulatory failure), correction of reparative processes (nutritional support, correction of myelo and immunodeficiencies).

Summary: Radiation reactions occur in 100% of patients undergoing radiation therapy, must be temporary, and can be significantly clinically pronounced, affecting the patient’s quality of life.

Radiation damage– this is a degenerative-dystrophic change in normal tissues, which is persistent and irreversible, occurring in the long-term period (peak frequency 1-2 years after radiation therapy). Radiation damage is mainly typical for systems with slow updates. The frequency of occurrence should be no more than 5%.

Main pathogenetic mechanism: damage to microcirculation vessels resulting in chronic ischemia and the development of processes of fibrosis of the organ parenchyma.

Vascular endothelium belongs to the slowly renewing F-systems, although a hierarchy of cells is structurally visible. Therefore, the endothelium reacts to irradiation late (after 4-6 months).

Possible changes in the endothelium:

1. uncontrolled hyperplasia of endothelial cells with subsequent occlusion of the lumen of the vessel

2. cellular devastation with emptying and thrombosis of the vessel.

Thus, an area of chronic ischemia develops in the parenchyma of the organ, which disrupts the trophism and restoration of parenchymal cells, and also provokes collagen synthesis and rapid tissue sclerosis.

The vascular pathogenesis of radiation damage is the most studied, but is not the leading one for all tissues. The following pathogenetic mechanisms are known:

- under the influence of radiation, it is possible to change the antigenic structure of biopolymers and cell membranes, which can induce autoimmune processes (AIT and hypothyroidism after neck irradiation, dilated cardiomyopathy)

- death of 2nd order pneumocytes can lead to a decrease in the synthesis of surfactant, collapse of the walls of the alveoli, and the development of bronchiolitis and alveolitis.

- high doses of ionizing radiation can cause demyelination of nerve fibers, gradual depletion of the pool of Schwann cells and oligodendroglial cells. These processes underlie damage to the structures of the central and peripheral nervous system, including the neuro-automatic system of the heart muscle.

— a decrease in the pool and functional activity of fibroblasts leads to incomplete resorption and “aging” of the structure of collagen fibers, which leads to loss of elasticity and excessive development of connective tissue.

Primary processes of fibrosis compress microcirculatory vessels and prevent neoangiogenesis, which aggravates trophic disorders and triggers a pathogenetic circle.

The likelihood of occurrence and severity of radiation damage depends on:

single and total radiation dose, fractionation regimen (large-fraction irradiation techniques are always more dangerous with the risk of developing damage than the classic version of radiation therapy)
volume of irradiation of a specific organ
the presence of other pathological processes in the irradiated tissue

Based on the requirements of the European Society of Radiological Oncology, the detection rate of radiation damage should not exceed 5%, and there should be no radiation damage of grade 3 or higher.

The average frequency of radiation injuries in the Russian Federation, which is published in official publications, is about 20%, but some authors talk about a frequency of at least 40%. Statistical study of this phenomenon is difficult due to the long time period after radiation therapy, the slowly progressive nature of the course, and the low awareness of doctors in matters of radiobiology and medical radiology.

Possible nosologies as a consequence of radiation damage.

With total brain irradiation in acute period the following phenomena are possible: headaches, nausea, vomiting, anorexia, asthenic syndrome, cerebral edema. And in the long-term period after this type of radiation therapy, most patients experience memory loss, mental and cognitive disorders, headaches, and in 20% of cases the development of dementia. The extreme degree of radiation damage to the brain during local high-dose irradiation is radionecrosis.

The spinal cord is very often included in the radiation field with any type of radiation therapy. In the long-term period, the formation of radiation myelitis is possible: paresthesia, impaired superficial and deep sensitivity, motor and pelvic disorders.

The structures of the eye are highly radiosensitive: radiation cataract, retinal and optic nerve atrophy.

Inner ear: sclerosis of the otolithic apparatus with progressive hearing loss.

When irradiating head and neck tumors in the long term, patients can experience chronic xerostomia due to sclerosis salivary glands, chronic periodontal disease with tooth loss.

Irradiation thyroid gland in the long term it can provoke AIT with progressive hypothyroidism.

The respiratory parenchyma of the lungs is highly radiosensitive, which determines the possibility of both acute radiation pneumonitis (often masked as infectious pneumonia) and the development of radiation pneumosclerosis 6-12 months after the end of the course of radiation therapy, which leads to a decrease in tidal volumes.

The mesothelium of the pleura, pericardium and peritoneum is highly radiosensitive tissue. In the acute period, it can react to irradiation in the form of fluid transfer, and in the long-term period - in the form of an adhesive process.

The main pathological processes during irradiation of the kidney parenchyma are observed in the proximal and distal parts of the convoluted tubules, as well as in the microcirculation vessels. The main pathological process is nephrosclerosis with decreased function.

Radiation damage to the dermis, ligamentous-articular apparatus and striated muscles follows the path of vascular pathogenesis with subsequent fibrosis and sclerosis of the tissue. Severe damage - joint ankylosis, radiation skin ulcer.

Cardiac toxicity of antitumor treatment is a very common and pressing problem today. The mediastinal area is very often included in the treatment volumes irradiated (breast cancer, lymphoma, lung cancer, esophagus). This is one of the most dangerous side effects, which affects both the quality of life of patients and survival rates.

Primary cardiac risk: age over 50 years, arterial hypertension, overweight, hyperlipidemia, atherosclerosis, smoking, diabetes.

In addition to the presence of risk factors, most modern cytostatics (even cyclophosphamide and 5-FU) have cardiotoxicity (in its various variants).

Even with high-precision radiation equipment, it is impossible to limit the mediastinum from radiation as much as possible, due to a decrease in the radicalism of treatment and tumor control.

Heart diseases caused by radiation therapy:

- acute effusion pericarditis (with outcome in chronic exudative, or adhesive pericarditis), hypotensive syndrome. Observed in the early period after and during the course of radiation therapy.

- angina pectoris and myocardial infarction (due to endarteritis of the coronary vessels). It's late by-effect, with a maximum frequency at 3-5 years of observation.

- diffuse interstitial fibrosis of the myocardium resulting in restrictive cardiomyopathy, rhythm disorders (sinus tachycardia, various variants atrial fibrillation, blockades). Fibrosis can lead to valve disorders (stenosis and insufficiency of the mitral and aortic valves)

— dilated cardiomyopathy as an outcome of autoimmune processes in the myocardium

- fibrosis of a large lung volume can lead to increased pressure in the lungs pulmonary artery with subsequent development pulmonary heart

- obstruction of venous and lymphatic vessels mediastinum after irradiation can provoke chronic exudative pleurisy and pericarditis or chylothorax.

As clinical observations and studies have shown, the total dose at which these pathological processes are possible is 30-40 Gy (in reality, the used SOD ranges from 46 to 70 Gy). And if we add to this the presence of primary cardiac problems, the behavior of massive cytostatic therapy, anesthesia, stress, then probability turns into inevitability.

Before starting treatment (including before chemotherapy), it is recommended: ECG, ultrasound of the heart (LVEF, diastolic indices), type-B natriuretic peptide, troponin.

Contraindication for cardiotoxic interventions(radiation therapy to the mediastinal area or cardiotoxic chemotherapy) are: initial LVEF less than 50%, or a decrease in LVEF by 20% from initial, even normal level, even in the absence clinical signs heart failure. Sub- and decompensation of pathology of the cardiopulmonary system is also a contraindication.

However, radiation therapy is a highly effective antitumor treatment method; the frequency of its use in treatment regimens or as an independent method is increasing. Clinical and radiobiological experience in working with sources of ionizing radiation is being accumulated. The main direction of development of radiation therapy is to minimize the impact of ionizing radiation on normal tissues, with a more precise and high-dose effect on a malignant tumor.