Randomised studies in locally advanced cervical cancer patients showed that cisplatin should be given concurrently with radiotherapy, because of a better long-term survival compared to radiotherapy alone. This increases the relevance of treatment related toxicity. This review summarises the acute and long-term toxicity of radiotherapy given with or without chemotherapy for cervical cancer. Acute toxicity (all grades) of radiotherapy is reported in 61% of the patients in the rectosigmoid, in 27% as urological, in 27% as skin and in 20% as gynaecological toxicity. Moderate and severe morbidity consists of 5% to 7% gastrointestinal and 1% to 4% genitourinary toxicity. Adding chemotherapy to radiotherapy increases acute haematological toxicity to 5% to 37% of the patients and nausea and vomiting in 12% to 14%. Late effects of radiotherapy include gastrointestinal, urological, female reproductive tract, skeletal and vascular toxicity, secondary malignancies and quality of life issues. For at least 20 years after treatment, new side effects may develop. Gastrointestinal toxicity usually occurs in the first 2 years after treatment in about 10% of the patients. The incidence of moderate and severe urological toxicity can increase up to 10% and rises over time. Gynaecological toxicity usually occurs shortly after treatment while skeletal and vascular toxicity can occur years to decades later. Thus far, no increase in late toxicity has been observed after the addition of cisplatin to radiotherapy. Finally, methods to prevent or decrease late toxicity and therapeutical options are discussed. However, most randomised studies still have a limited follow-up period.

中文翻译：

---

单独放疗或联合化疗后对于局部晚期宫颈癌的急性和长期毒性。

对局部晚期宫颈癌患者的随机研究表明，与单纯放疗相比，顺铂应与放疗同时使用，因为其长期生存期更好。这增加了与治疗有关的毒性的相关性。这篇综述总结了有或没有化疗对宫颈癌放疗的急性和长期毒性。据报道，放射治疗的急性毒性（所有级别）在直肠乙状结肠中占61％，在泌尿科中占27％，在皮肤中占27％，在妇科中占20％。中度和严重的发病率包括5％至7％的胃肠道和1％至4％的泌尿生殖道毒性。在放疗中添加化学疗法会使急性血液学毒性增加至5％至37％的患者，恶心和呕吐的患者会增加12％至14％的患者。放疗的后期影响包括胃肠道，泌尿科，女性生殖道，骨骼和血管毒性，继发性恶性肿瘤和生活质量问题。治疗后至少20年，可能会出现新的副作用。胃肠道毒性通常发生在约10％的患者接受治疗后的头2年。中度和重度泌尿系统毒性的发生率最高可增加10％，并随着时间的推移而上升。妇科毒性通常在治疗后不久发生，而骨骼和血管毒性可能在数年至数十年后发生。迄今为止，在放疗中加入顺铂后，未观察到后期毒性增加。最后，讨论了预防或减少晚期毒性的方法和治疗选择。然而，