Pelvic irradiation and its effects on the lower urinary tract: a literature review

The benefit of radiotherapy (RT) for pelvic tumors such as prostate and bladder cancer is well described. As cancer control rates improve, long-term survivorship issues become highly relevant to cancer management and it is essential to better understand the long-term effects of radiation. The risk and nature of radiation toxicity in a patient depend on treatment-related factors such as the total radiation dose, the dose per fraction, and schedule of treatment as well as patient-related factors like age, baseline lower urinary tract symptoms, previous surgery in an irradiated site, and co-morbidities. Radiation may also have a negative impact on the outcomes of surgical procedures for the treatment of lower urinary tract symptoms. Technical developments in radiation therapy such as intensity-modulated radiotherapy and the use of various forms of image-guided radiotherapy have enabled a decrease in the dose in organs surrounding the tumor that in many situations has reduced severe radiation-induced toxicities.