Acute and late effects of

The table below provides examples of some of the acute and late effects that patients may experience, according to tumour stream. Tumour stream Acute Late

Fatigue Fatigue All Radiation induced skin reaction Radiation induced second malignancy Erythema, dermatitis, Skin dry desquamation, moist , skin atrophy desquamation Permanent hair loss Alopecia Cognitive impairment Headache Brain injury/necrosis Somnolence (subacute) Neurological Endocrine dysfunction and vomiting Hearing loss and vestibular changes Otitis externa and media Cataracts Blindness Dysphagia/odynophagia Xerostomia Xerostomia Persistent taste alteration Dysgeusia Epiphora Mucositis Head and Neck Sensorineural hearing loss (serous otitis media) Tinnitus Brainstem injury Loss of appetite Hypothyroidism Nausea and/or vomiting Osteonecrosis of the jaw

Breast oedema Breast oedema and fibrosis Cardiac toxicity Breast Rib pain Rib fracture

Anorexia Anorexia Enteric strictures, ulceration or stenosis / (Cramping) Cardiomyopathy/pericardial effusion and fibrosis Upper GI Diarrhoea Lung fibrosis Nausea/vomiting Radiation Radiation nephropathy

Bronchitis Pulmonary fibrosis Respiratory Pneumonitis (sub acute) Pleural effusion

Erectile/Sexual dysfunction (impotence, dry/painful ejaculation, orgasmalgia) Obstructive urinary symptoms Radiation /enteritis Radiation cystitis/urethritis Urogenital Urethral stricture Radiation proctitis/enteritis Radiation cystitis/urethritis Radiation induced bone injury Diarrhoea Radiation cystitis Fatigue Radiation proctitis Cystitis Vaginal stenosis/dryness Skin erythema Sexual dysfunction/dyspareunia Epilation Menopause/infertility (if ovaries present) Gynaecological Menopausal symptoms Fatigue Bone marrow suppression Lymphoedema Nausea and/or Vomiting Small Proctitis Femoral neck fracture/ pelvic insufficiency fracture Vaginal mucositis Fistula Faecal incontinence Fatigue Femoral neck/pelvic fracture Infertility Radiation proctitis (PR bleeding/ Premature ovarian failure/menopause Mucous and rectal discomfort) Radiation proctitis (PR bleeding/mucous and rectal discomfort) Radiation cystitis Colorectal Radiation bowel injury Epilation Sexual dysfunction, vaginal dryness, stenosis/dyspareunia, Diarrhoea/enteritis Erectile dysfunction Bladder/ureteric fibrosis Anastomotic leakage Second malignancy Version 1.0