title: Management of toxicities following pelvic irradiation for gynaecological cancers.
abstract: OBJECTIVE
  With increasing numbers of cancer survivors, management of the consequences of treatment is a major clinical problem. This article discusses recent advances in preventing and managing radiotherapy-related toxicity.
  
  
  RESULTS
  Often underreported in clinical studies, radiation toxicity should be assessed with validated assessment tools to assess impact on quality of life. Prevention strategies targeting reactive oxygen species and proinflammatory cytokines show promise. Bowel toxicity is the most common late effect, and algorithm-led investigation and management can significantly improve outcomes. Oral and intravesical therapies are options for bladder toxicity if conservative measures fail.
  
  
  CONCLUSIONS
  With better understanding of the mechanisms of acute and chronic radiation-induced changes, more effective treatments are now possible. Following pelvic radiotherapy, patients should be proactively assessed for early intervention by a specialist multidisciplinary team.
authors.affiliation: Department of Gynaecology, Royal Marsden Hospital, London, UK.
authors.forename: Andreia
authors.initials: A
authors.lastname: Fernandes
authors.forename: Neel J
authors.initials: NJ
authors.lastname: Bhuva
authors.forename: Alexandra
authors.initials: A
authors.lastname: Taylor
mesh_terms: D004307:Dose-Response Relationship, Radiation; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D010386:Pelvic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D011832:Radiation Injuries / Q000473:pathology / Q000517:prevention & control*; D011879:Radiotherapy Dosage; D016896:Treatment Outcome