Table 3.

Radiotherapy side effects

LOCATIONACUTESUBACUTELATE
General

  • Fatigue

  • Second malignancy in the field of radiation (< 1% risk in older adults; higher risk in pediatric or younger populations

Skin

  • Sunburned appearance (erythema, pruritus)

  • Dry skin peeling (or dry desquamation)

  • Weeping skin (or wet desquamation)

  • Ulceration and bleeding (rare)

  • Decreased sweating

  • Hair loss

  • Tanning (hyperpigmentation or hypopigmentation)

  • Telangiectasia

  • Fibrosis

Lung

  • Cough

  • Radiation pneumonitis (syndrome of cough, dyspnea, hypoxia, fever, radiologic changes)

  • Reduced pulmonary function

Heart

  • No specific acute or subacute effects

  • Coronary artery disease

  • Pericarditis

Head and neck

  • Mucositis

  • Xerostomia (dry mouth)

  • Dysphagia

  • Odynophagia

  • Weight loss (from poor nutritional intake)

  • Dysphagia or odynophagia

  • Dysgeusia (changes in taste)

  • Voice changes

  • Dental complications

  • Osteonecrosis of the mandible (rare)

Esophagus

  • Esophagitis

  • Nausea

  • Anorexia

  • Esophageal perforation (rare)

  • Tracheoesophageal fistula (rare)

  • Esophageal stricture (rare)

Small and large bowel

  • Nausea and vomiting

  • Radiation colitis (rare)

Anorectal

  • Diarrhea

  • Mucus discharge from the rectum

  • Radiation proctitis (rare)

  • Chronic bowel habit change

  • Rectal urgency

  • Fistulae, strictures, obstructions (rare)

Bladder and prostate

  • Irritative or obstructive urinary symptoms

  • Sexual dysfunction

  • Radiation cystitis (rare)

  • Urethra stricture (rare)

Vagina

  • Vaginitis (irritation)

  • Vaginal stenosis

  • Fistula (rare)

Ovary

  • No specific acute or subacute effects

  • Induced menopause

  • Infertility

Brain

  • Increased ICP

  • Headache

  • Seizures

  • Nausea and vomiting

  • Fatigue

  • Cognitive decline

  • Cataracts (lens effects)

  • Hearing loss (cochlear effects)

  • Hormonal imbalance (pituitary or hypothalamic effects)

Bone

  • Marrow suppression

  • Pain flares

  • Fracture due to osteopenia

  • Bone growth arrest (pediatric)

  • ICP—intracranial pressure. Adapted from Ingledew et al.27