Complications of oncologic therapy in the abdomen and pelvis: a review

Abstract

Cancer therapy has significantly improved in the past few decades with development of various newer classes of cytotoxic chemotherapy as well as novel, molecularly targeted chemotherapy. Similar to chemotherapy, radiotherapy is another important therapeutic option used in the curative and palliative management of various abdominal malignancies. However, both these treatments affect the tumor as well as the normal tissues, leading to significant toxicity. These side effects range from mild to life threatening, and may involve multiple organs. Imaging plays an important role in the early identification of such complications, which may allow more effective patient management. The aim of this article is to discuss and illustrate the wide spectrum of chemotherapy and radiotherapy induced complications in the abdomen and pelvis.

Multi-modality organ-based approach to expected imaging findings, complications and recurrent tumour in the genitourinary tract after radiotherapy

“…4 and 5) [9]. The most common location of radiation-induced ureteric stricture is at or just above the uretero-vesicular junction [14]. Strictures can occur acutely (within 6 months of RT) but are more commonly seen in the chronic setting with latency periods reported up to 10 years after treatment [9, 14].…”

“…The most common location of radiation-induced ureteric stricture is at or just above the uretero-vesicular junction [14]. Strictures can occur acutely (within 6 months of RT) but are more commonly seen in the chronic setting with latency periods reported up to 10 years after treatment [9, 14]. In contrast to radiation-induced strictures, malignant strictures are irregular and tend to have abrupt and shouldered margins with an associated mass [14].…”

“…Strictures can occur acutely (within 6 months of RT) but are more commonly seen in the chronic setting with latency periods reported up to 10 years after treatment [9, 14]. In contrast to radiation-induced strictures, malignant strictures are irregular and tend to have abrupt and shouldered margins with an associated mass [14]. Other manifestations of ureteric injury following RT are rare and include fistula formation and reflux due to incompetence of the intramural portion of the ureter related to bladder fibrosis [15].…”

“…With haemorrhagic cystitis, high density can be seen in the bladder lumen [9]. Imaging findings with MRI are similar, although early changes of RT-induced cystitis are better depicted with T2-weighted sequences, which demonstrate variable degrees of increased signal in the bladder wall depending on the severity of the injury [9, 14]. Mild cystitis affects primarily the mucosa and submucosa, and severe toxicity results in transmural involvement (Fig.…”

“…7) [9]. MRI can demonstrate preferential involvement of the posterior bladder wall and trigone, with later involvement of the entire bladder [14]. Increased mucosal enhancement may be observed with contrast-enhanced CT or MRI [14].…”