Complication of radiotherapy

Acute effects

Microscopically it effects stem cells, so the acute effects relate to the time from stem cell division to natural course of sloughing from mucoasal / epithelial surface.

• Skin- thinning occurs and skin can slough 2 weeks. i.e time from stem cell division to desquamation
•  Gut –

Late effects

Late feaures of radiation damage relate:

• microscopically to fibrosis, enartertitis obliterans as a  result of hyalinisation.
• macroscopically to ulceration / iscahmia, stricturing, perforation, fistualtion

Clincally this produces

permanent sterility

parenchymal tissues that divide slowly e.g thyroid hypothyroidism can occur over months

Vascular – telangectasia, enartertitis obliterans results in poor perfusion and tissue ischaemia

Lymphatics channels obliterate - lymphoedema