Radiotherapy AND CHEMOTHERAPY

1. RADIOTHERAPY
&
CHEMOTHERAPY

2. •Radiotherapy and chemotherapy are the important
modalities of therapy for human cancers apart from
surgery.
•They may have a curative role
–Radiotherapy in carcinoma cervix and
–Chemotherapy in gestational trophoblastic neoplasia

3. RADIOTHERAPY

4. • Radiotherapy plays a major role in the treatment of patients with
Gynaecological malignancies.
• CT, MRI, OPTIMISED INVERSE PLANNING, COMPUTER CONTROLLED
TREATMNET DELIVERY, BRACHYTHERAPY these techniques enable
radiation oncologist to restrict radiation dose distribution to specified
target volumes.
• Maximal dose is delivered to tumour, while normal tissue is spared.

5. RADIOBIOLOGY OF NORMAL TISSUES
• A. Loss of mature functional cells by apoptosis This usually occurs
within 24 hours of radiation.
• B. Loss of cellular reproductive capacity. The severity depends upon
the total dose of radiation, length of time over which radiotherapy is
delivered and the radiosensitivity of the particular cell types.

6. • C. The critical target for most radiation induced cell death is
the DNA within the cells nucleus.  Photons or charged
particles interact with intracellular water to produce free
radicals. Free radicals interact with DNA causing Breakage
 inablitiy to reproduce.

7. IONIZING RADIATION
•(i) Electromagnetic radiation
–(X –Rays, Gamma rays)
•(ii) Particulate radiation.
–Electrons, Protons, Neutrons

8. TECHNIQUES OF RADIATION THERAPY
• BRACHYTHERAPY  very high dose of radiation is given
where the source is placed within or close to the tumour
– Intracavitary  device with hollow stem placed within the uterine
cavity
– Interstitial  radioactive sources like needles, wires or seeds within
the tissue.

9. • EXTERNAL BEAM RADIOTHERAPY/ TELETHERAPY
 beams of ionising radiation produced from a source
external to the patient .
• INSTILLATION OF RADIOISOTOPED INTO THE
PERITONEAL OR PLEURAL CAVITY.

10. COMPLICATION
OF
RADIOTHERAPY

13. CHEMOTHERAPY

14. OBJECTIVES
• Complete remission of the tumor
• Partial remission with improvement of median survival
• To prevent recurrence of the tumor
• To help in palliation.

15. COMPLICATION
OF
CHEMOTHERAPY

16. • GIT  nausea, vomiting, oral ulceration, stomatitis, necrotizing
enterocolitis, diarrhea
• Hair roots  Alopecia
• hematological  Anemia
• Skin  dermatitis, pigmentation, skin necrosis
• Cardiac  Cardiomyopathy, arrhythmias, endocardial fibrosis
• Liver  Hepatitis
• Lungs  Fibrosis

17. • Nervous system  Peripheral neuropathy
• Urinary system  Renal failure, azotemia, hemorrhagic cystitis, red
urine
• Immune system  Suppression of cellular and humoral immunity, loss
of host defense mechanism
• Gonads  Infertility, amenorrhoea, Premature Ovarian failure.