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Gynecologic Cancer

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Skin Care in Radiation Oncology

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Abstract

Tumors affecting the gynecological organs invariably carry a risk for reproductive, sexual, cosmetic, and emotional consequences due to their unique location. Moreover, due to their proximity to the external genitourinary and lower gastrointestinal tracts, skin toxicity as a result of treatment is one of the most important determinants for patient tolerance and compliance during a course of radiotherapy, especially when the external genitalia is included in the radiation field.

Factors affecting skin toxicity include appositional skin in the radiation field, external genitalia in the radiation field, body habitus/obesity, concurrent chemotherapy, patient age, and immunocompromised or actively smoking patients.

Due to heat and moisture trapping, it is easy for a fungus to overgrow and cause an infection. Moreover, the presence of urine and stool near irritated skin can significantly increase the risk for bacterial infection. A physician should closely examine skin in the irradiated field at least weekly during a course of radiation therapy in order to diagnose these superimposed infections early so that treatment can be initiated. Frequent sitz baths and meticulous hygiene are important to help minimize the risk of bacterial infection.

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References

  1. Ferlay J, Soerjomataram I, Ervik M, Eser S, Mathers C, Rebelo M, et al. GLOBOCAN 2012 v1.1, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 International Agency for Research on Cancer; World Health Organization. 2014. http://globocan.iarc.fr/Default.aspx. Accessed 3 August 2015.

  2. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014;64:9–29. doi:10.3322/caac.21208.

    Article  PubMed  Google Scholar 

  3. McBride WH, Withers R. Biologic basis of radiation therapy. In: Halperin EC, Perez CA, Brady LW, editors. Perez and Brady's principles and practice of radiation oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2008.

    Google Scholar 

  4. Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0. In: Cancer Therapy Evaluation Program. National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services. 2010. http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010–06–14_QuickReference_8.5x11.pdf. Accessed 16 April 2015.

  5. RTOG Acute Radiation Morbidity Scoring Criteria. Radiation Therapy Oncology Group. 2015. http://www.rtog.org/ResearchAssociates/AdverseEventReporting/AcuteRadiationMorbidityScoringCriteria.aspx. Accessed 4 May 2015.

  6. Keys HM, Bundy BN, Stehman FB, Muderspach LI, Chafe WE, Suggs 3rd CL, et al. Cisplatin, radiation, and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med. 1999;340:1154–61. doi:10.1056/NEJM199904153401503.

    Article  CAS  PubMed  Google Scholar 

  7. Morris M, Eifel PJ, Lu J, Grigsby PW, Levenback C, Stevens RE, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med. 1999;340:1137–43. doi:10.1056/NEJM199904153401501.

    Article  CAS  PubMed  Google Scholar 

  8. Peters 3rd WA, Liu PY, Barrett 2nd RJ, Stock RJ, Monk BJ, Berek JS, et al. Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol. 2000;18:1606–13.

    CAS  PubMed  Google Scholar 

  9. Rose PG, Bundy BN, Watkins EB, Thigpen JT, Deppe G, Maiman MA, et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999;340:1144–53. doi:10.1056/NEJM199904153401502.

    Article  CAS  PubMed  Google Scholar 

  10. Whitney CW, Sause W, Bundy BN, Malfetano JH, Hannigan EV, Fowler Jr WC, et al. Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol. 1999;17:1339–48.

    CAS  PubMed  Google Scholar 

  11. Roberts KB, Urdaneta N, Vera R, Vera A, Gutierrez E, Aguilar Y, et al. Interim results of a randomized trial of mitomycin C as an adjunct to radical radiotherapy in the treatment of locally advanced squamous-cell carcinoma of the cervix. Int J Cancer. 2000;90:206–23.

    Article  CAS  PubMed  Google Scholar 

  12. Wong LC, Ngan HY, Cheung AN, Cheng DK, Ng TY, Choy DT. Chemoradiation and adjuvant chemotherapy in cervical cancer. J Clin Oncol. 1999;17:2055–60.

    CAS  PubMed  Google Scholar 

  13. Sitton E. Early and late radiation-induced skin alterations. Part I: Mechanisms of skin changes. Oncol Nurs Forum. 1992;19:801–7.

    CAS  PubMed  Google Scholar 

  14. Frank SJ, Jhingran A, Levenback C, Eifel PJ. Definitive radiation therapy for squamous cell carcinoma of the vagina. Int J Radiat Oncol Biol Phys. 2005;62:138–47. doi:10.1016/j.ijrobp.2004.09.032.

    Article  PubMed  Google Scholar 

  15. Mak RH, Halasz LM, Tanaka CK, Ancukiewicz M, Schultz DJ, Russell AH, et al. Outcomes after radiation therapy with concurrent weekly platinum-based chemotherapy or every-3–4-week 5-fluorouracil-containing regimens for squamous cell carcinoma of the vulva. Gynecol Oncol. 2011;120:101–7. doi:10.1016/j.ygyno.2010.09.004.

    Article  CAS  PubMed  Google Scholar 

  16. Moore DH, Thomas GM, Montana GS, Saxer A, Gallup DG, Olt G. Preoperative chemoradiation for advanced vulvar cancer: a phase II study of the Gynecologic Oncology Group. Int J Radiat Oncol Biol Phys. 1998;42:79–85.

    Article  CAS  PubMed  Google Scholar 

  17. Beriwal S, Coon D, Heron DE, Kelley JL, Edwards RP, Sukumvanich P, et al. Preoperative intensity-modulated radiotherapy and chemotherapy for locally advanced vulvar carcinoma. Gynecol Oncol. 2008;109:291–5. doi:10.1016/j.ygyno.2007.10.026.

    Article  PubMed  Google Scholar 

  18. Moore DH, Ali S, Koh WJ, Michael H, Barnes MN, McCourt CK, et al. A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally-advanced squamous cell carcinoma of the vulva: a gynecologic oncology group study. Gynecol Oncol. 2012;124:529–33. doi:10.1016/j.ygyno.2011.11.003.

    Article  CAS  PubMed  Google Scholar 

  19. Montana GS, Kang SK. Carcinoma of the Vulva. In: Halperin EC, Perez CA, Brady LW, editors. Perez and Brady's principles and practice of radiation oncology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2008.

    Google Scholar 

  20. Kouvaris JR, Kouloulias VE, Plataniotis GA, Balafouta EJ, Vlahos LJ. Dermatitis during radiation for vulvar carcinoma: prevention and treatment with granulocyte-macrophage colony-stimulating factor impregnated gauze. Wound Repair Regen. 2001;9:187–93.

    Article  CAS  PubMed  Google Scholar 

  21. Dandapani SV, Zhang Y, Jennelle R, Lin YG. Radiation-Associated Toxicities in Obese Women with Endometrial Cancer: More Than Just BMI? ScientificWorldJournal. 2015;2015:483208. doi:10.1155/2015/483208.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kirwan JM, Symonds P, Green JA, Tierney J, Collingwood M, Williams CJ. A systematic review of acute and late toxicity of concomitant chemoradiation for cervical cancer. Radiother Oncol. 2003;68:217–26.

    Article  PubMed  Google Scholar 

  23. Green J, Kirwan J, Tierney J, Vale C, Symonds P, Fresco L, et al. Concomitant chemotherapy and radiation therapy for cancer of the uterine cervix. Cochrane Database Syst Rev. 2005:CD002225. doi: 10.1002/14651858.CD002225.pub2.

  24. Green JA, Kirwan JM, Tierney JF, Symonds P, Fresco L, Collingwood M, et al. Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: a systematic review and meta-analysis. Lancet. 2001;358:781–6. doi:10.1016/S0140-6736(01)05965-7.

    Article  CAS  PubMed  Google Scholar 

  25. Hoffman KE, Horowitz NS, Russell AH. Healing of vulvo-vaginal radionecrosis following revascularization. Gynecol Oncol. 2007;106:262–4. doi:10.1016/j.ygyno.2007.03.038.

    Article  PubMed  Google Scholar 

  26. Lybeert ML, Meerwaldt JH, van Putten WL. Age as a prognostic factor in carcinoma of the cervix. Radiother Oncol. 1987;9:147–51.

    Article  CAS  PubMed  Google Scholar 

  27. Huang HJ, Chang TC, Hong JH, Tseng CJ, Chou HH, Huang KG, et al. Prognostic value of age and histologic type in neoadjuvant chemotherapy plus radical surgery for bulky (>/=4 cm) stage IB and IIA cervical carcinoma. Int J Gynecol Cancer. 2003;13:204–11.

    Article  PubMed  Google Scholar 

  28. Wright JD, Gibb RK, Geevarghese S, Powell MA, Herzog TJ, Mutch DG, et al. Cervical carcinoma in the elderly: an analysis of patterns of care and outcome. Cancer. 2005;103:85–91. doi:10.1002/cncr.20751.

    Article  PubMed  Google Scholar 

  29. Spanos Jr WJ, King A, Keeney E, Wagner R, Slater JM. Age as a prognostic factor in carcinoma of the cervix. Gynecol Oncol. 1989;35:66–8.

    Article  PubMed  Google Scholar 

  30. Gao Y, Ma JL, Gao F, Song LP. The evaluation of older patients with cervical cancer. Clin Interv Aging. 2013;8:783–8. doi:10.2147/CIA.S45613.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Caires IQ, Souza KT, Negrao MV, de Oliveira JA, Barroso-Sousa R, de Lima RC, et al. Definitive chemoradiotherapy for advanced cervical cancer: should it be different in the elderly? Eur J Obstet Gynecol Reprod Biol. 2015;192:86–9. doi:10.1016/j.ejogrb.2015.05.007.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiation Oncology, University of California, San Francisco, Box 1708, 1600 Divisadero, Cancer Centre Room 1029, San Francisco, CA, 94143, USA

    Tracy Sherertz MD & Jennifer Bohm RN, BSN

Authors
  1. Tracy Sherertz MD
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  2. Jennifer Bohm RN, BSN
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Corresponding author

Correspondence to Tracy Sherertz MD .

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, University of California San Francisco, San Francisco, California, USA

    Barbara Fowble

  2. Department of Radiation Oncology, University of California San Francisco, San Francisco, California, USA

    Sue S. Yom

  3. Department of Radiation Oncology, University of California San Francisco, San Francisco, California, USA

    Florence Yuen

  4. Department of Dermatology, University of California San Francisco, San Francisco, California, USA

    Sarah Arron

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© 2016 Springer International Publishing Switzerland

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Sherertz, T., Bohm, J. (2016). Gynecologic Cancer. In: Fowble, B., Yom, S., Yuen, F., Arron, S. (eds) Skin Care in Radiation Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-31460-0_10

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  • DOI: https://doi.org/10.1007/978-3-319-31460-0_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31458-7

  • Online ISBN: 978-3-319-31460-0

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