Soft tissue radionecrosis is a condition that occurs when radiation exposure disrupts the blood supply to your soft tissues, killing cells and preventing them from regenerating normally. It most commonly occurs months or years after cancer treatment in or around areas where you received radiation therapy.
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What Is Soft Tissue Radionecrosis?
Soft tissue radionecrosis is a condition that occurs when radiation exposure disrupts the blood supply to your soft tissues, killing cells and preventing them from regenerating normally. It most commonly occurs months or years after cancer treatment in or around areas where you received radiation therapy.
What does radionecrosis mean?
Radionecrosis — also known as radiation necrosis — means that radiation therapy (radio) has caused tissue death (necrosis).
What are the types of soft tissue radionecrosis?
Types of soft tissue necrosis depend on the area that is damaged, including:
- Cerebral radiation necrosis — Causes brain damage.
- Laryngeal radionecrosis — Causes damage to your larynx, including voice changes.
- Oral cavity ulceration — Causes sores or ulcers in your mouth.
- Radiation cystitis — Causes damage to your bladder.
- Radiation proctitis, enteritis, or colitis — Causes inflammation in your small intestine, colon, or rectum.
- Surgical wound dehiscence — Causes problems with wound healing.
- Vaginal radionecrosis — Causes damage to vaginal tissue.
How common is soft tissue radionecrosis?
Soft tissue radionecrosis is rare, affecting about 3% to 5% of people who receive radiation therapy. It is more common in people who receive higher doses of radiation.
What causes soft tissue radionecrosis?
Soft tissue radionecrosis is caused by exposure to radiation during radiation therapy to treat cancer. Although radiation beams are precisely aimed at the tumor during radiation therapy, surrounding tissues are also exposed to radiation. Radiation exposure to healthy tissue can damage its blood supply, causing a lack of oxygen that leads to necrosis (tissue death).
Soft tissue radionecrosis risk factors
Risk factors for soft tissue radionecrosis include:
Complications of soft tissue radionecrosis
Soft tissue radionecrosis complications include:
- Nonhealing wounds.
- Pain.
- Ulceration (breaks in the skin or tissue).
How can I prevent soft tissue radionecrosis?
You may not be able to prevent soft tissue radionecrosis. However, before you start radiation therapy, your doctor can recommend strategies to reduce your risk.
What Are the Signs and Symptoms of Soft Tissue Radionecrosis?
Symptoms of soft tissue radionecrosis typically appear six months to several years after radiation therapy and may include:
- Hair loss.
- Infection.
- Pain.
- Problems with wound healing.
- Redness, discoloration, or changes in skin texture.
- Swelling.
- Ulceration.
When should I see a doctor about my soft tissue radionecrosis symptoms?
If you have soft tissue radionecrosis symptoms, schedule an appointment with your doctor right away. Receiving early treatment may help prevent the progression of your condition and reduce your risk of complications.
How Do You Diagnose Soft Tissue Radionecrosis?
To diagnose soft tissue radionecrosis, your doctor will ask you about your symptoms and medical history and perform a physical exam. Your doctor may also order imaging tests.
What to expect during your visit
If your doctor suspects soft tissue radionecrosis, they will:
- Perform a physical exam.
- Ask you about your symptoms.
- Order imaging tests.
Tests to diagnose soft tissue radionecrosis
Tests to help your doctor diagnose soft tissue radionecrosis may include:
- Biopsy — A procedure to take a small sample of abnormal tissue for analysis in a lab.
- CT scan — A test that creates images of your body's organs, bones, and tissues.
- MRI — To pinpoint damaged areas of tissue and help doctors develop a treatment plan.
- PET/CT — An imaging test that can identify necrotic tissue.
Soft tissue radionecrosis prognosis
Dead tissue can’t be saved, but getting early treatment can prevent the progression of soft tissue radionecrosis and reduce your risk of complications.
How long is life expectancy with radiation necrosis?
Severe soft tissue radionecrosis may affect your life expectancy. However, other factors, such as your age, overall health, and treatment success, can also affect survival. Your doctor will discuss your estimated life expectancy with you.
How Do You Treat Soft Tissue Radionecrosis?
The goals of soft tissue radionecrosis treatment are to stop the progression of the condition, promote wound healing, and reduce your risk of complications. Treatment options depend on the location of your soft tissue radionecrosis and may include:
Systemic hyperbaric oxygen therapy for soft tissue radionecrosis
Hyperbaric oxygen therapy (HBOT) involves using oxygen at a level higher than atmospheric pressure to deliver a greater-than-normal amount of oxygen to your body's tissues. Your blood carries this oxygen throughout your body, stimulating the release of substances called growth factors and stem cells, which strengthen your body’s natural wound-healing mechanisms and promote healing.
Wound debridement for soft tissue radionecrosis
Wound debridement is the removal of infected or nonviable tissue from your wound site to speed healing. Depending on the severity of your wound, debridement may be performed at your bedside or in the operating room. It can be a primary treatment or one step in a treatment plan, such as debridement of your wound to prepare the area for bioengineered skin substitutes or in combination with HBOT.
Surgery for soft tissue radionecrosis
Our wound care teams have experienced orthopaedic, vascular, podiatric, and plastic surgeons who can assess and treat all types of nonhealing wounds.
Our interdisciplinary approach means that your surgical team consults with your primary care physician as well as other wound healing experts. We will create a comprehensive, customized treatment plan, including post-surgical wound care, to help you return to your daily life as soon as possible.
Bioengineered skin substitute for soft tissue radionecrosis
UPMC’s cellular tissue-based products closely resemble human skin in structure and function, and they can be used temporarily or permanently to:
- Close wounds.
- Promote healing.
- Reduce pain.
- Eliminate the need for surgical skin grafts.
Why Choose UPMC for Soft Tissue Radionecrosis Care?
When you choose UPMC for soft tissue radionecrosis care, you will receive:
- Access to world-class wound care expertise — Our world-renowned experts treat all types of nonhealing wounds using the latest approaches and techniques.
- A full range of treatment options — We offer advanced care to manage soft tissue radionecrosis while reducing your risk of complications.
- Multidisciplinary care — We partner with orthopaedic, vascular, podiatric, and plastic surgeons who can provide complete nonhealing wound care that optimizes your recovery and quality of life.
