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Table 1 Early and late IR-induced tissue toxicity

From: Biological consequences of cancer radiotherapy in the context of oral squamous cell carcinoma

◦ Skin erythema
◦ Dry or moist skin desquamation
◦ Mucositis
◦ Nausea and diarrhoea
◦ Xerostomia
◦ Osteoradionecrosis
◦ Fibrosis
◦ Atrophy
◦ Neural damage
◦ Second malignancies
◦ Reduced organ functioning
◦ Xerostomia
◦ Osteoradionecrosis
◦ Dysphagia
  1. Legend: Early toxicity appears within a few weeks and late toxicity within months to years from completion of the course of IR. In general, early effects are transient and resolve within a few weeks but late effects are often irreversible and are progressive in nature. The signs, symptoms and functional impairment of IR-induced toxicity is a function of many interconnecting factors including the tissue/organs affected, the specific program of the delivered IR and one’s general health and genetic make-up. Early and late toxicity limits the potency of IR which can be safely delivered, but still be curative [10, 21,22,23,24]. Optimizing IR dose distribution, radiosensitizing cancer cells and radioprotecting adjacent normal tissues may go a long way in limiting IR-induced toxicity. Thus, the use of radiomodulators that selectively either increase protection of normal tissues against, or increase sensitization of cancer cells to IR, will allow the safe use of higher dose of IR, which may increase the prospects of radiocurability [9, 21].