[Somatic sequelae of radiotherapy: the possibility of surgery]

Abstract

The possibilities of surgical treatment for sequelae from radiotherapy in different organs and apparatuses are examined. Clinical severity of such sequelae is correlated to the causal factors: dose and its distribution with time, physiological status and volume of the irradiated tissues, association of the radiotherapy with chemotherapy and/or surgical treatments. For sequelae in the soft tissue the main question is to find trophic tissues for surgical wounds; plastic surgery is very often unavoidable. For osseous sequelae, when the administered dose was relatively low, conservative treatments are sufficient to cure. As regards sequelae of the digestive tract derivative surgical treatment is advisable, rather than resections with end to end anastomoses, when the administered dose is rather high; after low doses, sequelae are most frequently represented by easily removable bridles. For sequelae in the brain, nervous plexuses, heart, eye, surgical treatment can be useful, even if frequently with palliative results. The opportunity of integration of medical and surgical treatments is also examined.