Michael J McKay1,2,3, Richard Foster1. 1. Northern Cancer Service, North West Cancer Centre, Burnie, Tasmania, Australia. 2. Rural Clinical School, The University of Tasmania, Northwest Regional Hospital, Burnie, Tasmania, Australia. 3. Olivia Newton John Cancer Research Institute, Heidelberg, Victoria, Australia.
Abstract
OBJECTIVE: To review the pathobiology, irradiation dosimetric parameters and other risk factors, and therapy of radiation-induced gastric damage (RIGD). BACKGROUND: RIGD is a side-effect of upper abdominal radiotherapy. Acute toxicities are usually mild and self-limiting. Late toxicities are potentially life-threatening and include bleeding, perforation or stenosis. The data on RIGD is mainly historical and derived from neoplasms and treatments where the role of radiotherapy is contracting, such as para-aortic nodal irradiation for testis and cervical cancer and Hodgkin's Disease. On the other hand, the role of radiotherapy is expanding, especially with stereotactic body radiotherapy (SBRT) treatments evolving for both primary and secondary upper gastrointestinal neoplasms, which might be expected to increase the frequency of RIGD. Pathoclinical and radiation dosimetric data which might predict the risk of RIGD are evaluated. METHODS: English language articles between 1945 and December 2020, using PubMed and Embase, searching titles for keywords including: radiation; ionizing; radiotherapy; gastritis and 65 articles were selected for review. There may have been a risk of bias in the studies evaluated, since the majority of reports were retrospective, largely descriptive and qualitative. CONCLUSIONS: A common pathoclinical theme in RIGD is inflammation. Numerous factors predict for a greater likelihood of RIGD, including radiation fraction size and dose, concurrent chemotherapy and previous abdominal surgery. Therapy is pathology-dependent and comprises pharmacological, interventional and in the most severe cases, surgical approaches. It is timely to review the topic of RIGD, discuss the limitations of the data and highlight the need for future research directions. 2021 Journal of Gastrointestinal Oncology. All rights reserved.
OBJECTIVE: To review the pathobiology, irradiation dosimetric parameters and other risk factors, and therapy of radiation-induced gastric damage (RIGD). BACKGROUND: RIGD is a side-effect of upper abdominal radiotherapy. Acute toxicities are usually mild and self-limiting. Late toxicities are potentially life-threatening and include bleeding, perforation or stenosis. The data on RIGD is mainly historical and derived from neoplasms and treatments where the role of radiotherapy is contracting, such as para-aortic nodal irradiation for testis and cervical cancer and Hodgkin's Disease. On the other hand, the role of radiotherapy is expanding, especially with stereotactic body radiotherapy (SBRT) treatments evolving for both primary and secondary upper gastrointestinal neoplasms, which might be expected to increase the frequency of RIGD. Pathoclinical and radiation dosimetric data which might predict the risk of RIGD are evaluated. METHODS: English language articles between 1945 and December 2020, using PubMed and Embase, searching titles for keywords including: radiation; ionizing; radiotherapy; gastritis and 65 articles were selected for review. There may have been a risk of bias in the studies evaluated, since the majority of reports were retrospective, largely descriptive and qualitative. CONCLUSIONS: A common pathoclinical theme in RIGD is inflammation. Numerous factors predict for a greater likelihood of RIGD, including radiation fraction size and dose, concurrent chemotherapy and previous abdominal surgery. Therapy is pathology-dependent and comprises pharmacological, interventional and in the most severe cases, surgical approaches. It is timely to review the topic of RIGD, discuss the limitations of the data and highlight the need for future research directions. 2021 Journal of Gastrointestinal Oncology. All rights reserved.
Authors: Brian D Kavanagh; Charlie C Pan; Laura A Dawson; Shiva K Das; X Allen Li; Randall K Ten Haken; Moyed Miften Journal: Int J Radiat Oncol Biol Phys Date: 2010-03-01 Impact factor: 7.038
Authors: Alexis Bujold; Christine A Massey; John J Kim; James Brierley; Charles Cho; Rebecca K S Wong; Rob E Dinniwell; Zahra Kassam; Jolie Ringash; Bernard Cummings; Jenna Sykes; Morris Sherman; Jennifer J Knox; Laura A Dawson Journal: J Clin Oncol Date: 2013-04-01 Impact factor: 44.544