title: [Radiotherapeutic management of lymphatic fistulas : An effective but disregarded therapy option].
abstract: BACKGROUND
  Lymphatic fistulas and lymphoceles are known complications after vascular surgery of the groin and after extended surgical interventions in the pelvic region. Unfortunately, conservative standard therapies are not always successful.
  
  
  OBJECTIVE
  Evaluation of the therapeutic efficacy and related side effects of percutaneous low-dose irradiation in patients with lymphorrhea and definition of its importance.
  
  
  METHODS
  Current presentation of previously published case series, reviews and guidelines.
  
  
  RESULTS
  The use of low-dose irradiation therapy with single doses of 0.3-0.5 Gy leads to a cessation of the lymphatic flow in a high percentage of patients when standard therapies do not show a sufficient effect. With cessation of lymphorrhea irradiation should be terminated. Acute side effects have not been reported and the risk of tumor induction is almost negligible.
  
  
  CONCLUSIONS
  Low-dose irradiation is an effective and very well-tolerated therapeutic alternative in the treatment of lymphatic fistulas and lymphorrhea when conservative therapies are unsuccessful.
authors.affiliation: Klinik für RadioOnkologie und Strahlentherapie, Klinikum rechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland. daniel.habermehl@tum.de.|Institut für Innovative Radiotherapie (IRT), Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Oberschleißheim, Deutschland. daniel.habermehl@tum.de.
authors.forename: D
authors.initials: D
authors.lastname: Habermehl
authors.affiliation: Klinik für RadioOnkologie und Strahlentherapie, Klinikum rechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland.
authors.forename: G
authors.initials: G
authors.lastname: Habl
authors.affiliation: Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie, Klinikum rechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland.
authors.forename: H-H
authors.initials: HH
authors.lastname: Eckstein
authors.affiliation: Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie, Klinikum rechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Meisner
authors.affiliation: Klinik für RadioOnkologie und Strahlentherapie, Klinikum rechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland.|Institut für Innovative Radiotherapie (IRT), Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Oberschleißheim, Deutschland.
authors.forename: S E
authors.initials: SE
authors.lastname: Combs
mesh_terms: D054893:Cone-Beam Computed Tomography / Q000379:methods; D019583:Dose Fractionation, Radiation; D005260:Female; D005402:Fistula / Q000532:radiotherapy*; D006801:Humans; D007264:Inguinal Canal; D008197:Lymph Node Excision; D008206:Lymphatic Diseases / Q000532:radiotherapy*; D015182:Lymphatic Irradiation / Q000379:methods*; D008210:Lymphocele / Q000532:radiotherapy; D008297:Male; D011183:Postoperative Complications / Q000532:radiotherapy*; D017410:Practice Guidelines as Topic; D011879:Radiotherapy Dosage; D011881:Radiotherapy, Computer-Assisted / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D016896:Treatment Outcome
keywords: Low-dose irradiation; Lymphatic fistula; Lymphocele; Lymphorrhea; Radiotherapy