| | Cancer | Radiation Therapy
Chemotherapy and Radiation Therapy: Major Adverse Effects Overview
Both modalities target rapidly dividing cells, causing on-target toxicity in normal tissues. Understanding common side effects enables proactive management.
Chemotherapy: Systemic Toxicities
| Organ System | Key Effects | Monitoring/Mitigation |
|---|---|---|
| Hematologic | Neutropenia, anemia, thrombocytopenia | CBC q cycle; G-CSF for febrile neutropenia risk |
| GI | Nausea/vomiting (acute/delayed), mucositis, diarrhea | 5-HT3/NK1/dexamethasone prophylaxis; oral care |
| Dermatologic | Alopecia, hand-foot syndrome, rash, nail changes | Scalp cooling (alopecia); urea creams (HFS) |
| Renal | Tubular toxicity (cisplatin), hemorrhagic cystitis (cyclophosphamide) | Hydration, mesna, dose adjustment |
| Hepatic | Sinusoidal obstruction, steatohepatitis | LFTs monitoring |
| Cardiac | Anthracycline cardiomyopathy, 5-FU ischemia | Echo/MUGA baseline/serial; dexrazoxane |
| Pulmonary | Bleomycin pneumonitis/fibrosis | PFTs; avoid high O₂ |
| Neurologic | Peripheral neuropathy (platinums, taxanes, vinca) | Dose reduction; duloxetine for CIPN |
| Reproductive | Gonadal failure, infertility | Fertility preservation counseling pre-treatment |
| Secondary malignancy | AML/MDS (alkylators, topoisomerase II inhibitors), solid tumors | Long-term survivorship screening |
| Site | Acute | Late |
|---|---|---|
| Skin | Erythema, desquamation | Fibrosis, telangiectasia, pigment change |
| Mucosa | Mucositis, dysphagia, proctitis | Stricture, fistula, atrophy |
| Organ-specific | Pneumonitis (lung), cystitis (bladder), enteritis (bowel) | Fibrosis, secondary cancer, vascular injury |
| Systemic | Fatigue (universal) | — |