Radiotherapy treatments

Radiotherapy is the treatment of choice in patients with stage IIB, III and IV disease, and most patients with stage IIA disease. Stage IB tumours may be treated by radiotherapy if the lesion is of sufficient size that extensive surgical resection is required, with consequent increased risk of postoperative bladder dysfunction.

Stages I, II, and III are usually treated with a combination intracavity radioisotope and high-energy external radiation therapy, for example caesium-137.

Stage IV is treated by external radiotherapy if the disease is confined to the pelvis. Spread outside the pelvis is an indication for chemotherapy.

Complications of radiotherapy may include:

• fatigue and diarrhoea during treatment; the diarrhoea may persist after the treatment is completed
• proctitis, cystitis and rarely, fistula formation
• vaginitis and dyspareunia
• vaginal stenosis - rare if dilators used regularly during treatment
• loss of ovarian function - may necessitate HRT to overcome abrupt onset of menopausal symptoms in premenopausal women