Nutritional management of patients before, during and after therapeutic pelvic radiation

Therapeutic pelvic radiation is used with or without chemotherapy to treat malignancies of the pelvis that arise from gynecologic, genitourinary, and gastrointestinal organs. Along with the malignant tissue, which is the target of the radiation beam, adjacent organs are commonly included in the radiation field. This results in immediate and late complications. More specifically, the urinary bladder and the gastrointestinal tract are radiation sensitive and commonly symptoms arise from inflammation in these organs. More than 70% of patients who receive pelvic irradiation develop inflammation of the gastrointestinal tract and manifest symptoms of varying severity. More than half of these patients will develop chronic enteritis which will affect their quality of life. The role of the dietitian can be particularly important in the management of the acute and chronic problems of these patients. In the present review, we will attempt to describe the dietitian’s role and critically evaluate the dietary changes needed to improve enteritis in patients who have received therapeutic pelvis irradiation.