LATE EFFECTS OF RADIATION-THERAPY ON THE GASTROINTESTINAL-TRACT
LATE EFFECTS OF RADIATION-THERAPY ON THE GASTROINTESTINAL-TRACT
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DOI：
10.1016/0360-3016(94)00419-l
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发表时间：
1995-03-30
影响因子：
7
通讯作者：
TEPPER, JE
中科院分区：
文献类型：
--
作者：
COIA, LR;MYERSON, RJ;TEPPER, JE
放射治疗的晚期胃肠道并发症已被认识到，但尚未得到广泛研究。在本文中，辐射对三个胃肠道部位，食管，胃和肠的远期影响进行了描述。食管放射后的食管动力障碍和良性狭窄主要是食管壁损伤的结果，尽管粘膜溃疡也可能在高剂量放射后持续存在。胃照射后的主要晚期并发症是粘膜破坏引起的胃溃疡。肠的晚期辐射损伤可能导致出血、频繁、瘘管形成，特别是在小肠中，肠梗阻是由肠壁的整个厚度的损伤引起的，并且已经确定了诱发因素。对于每个网站的发病机制，临床表现和目前的管理提供了一个描述。开发了用于晚期毒性测量的简单且可重复的终点量表，并针对三个胃肠道器官中的每一个列出。分析晚期并发症的重要因素和放射相关胃肠道损伤的评估和管理的未来考虑进行了讨论。
Late gastrointestinal complications of radiation therapy have been recognized but not extensively studied. In this paper, the late effects of radiation on three gastrointestinal sites, the esophagus, the stomach, and the bowel, are described. Esophageal dysmotility and benign stricture following esophageal irradiation are predominantly a result of damage to the esophageal wall, although mucosal ulcerations also may persist following high-dose radiation. The major late morbidity following gastric irradiation is gastric ulceration caused by mucosal destruction. Late radiation injury to the bowel, which may result in bleeding, frequency, fistula formation, and, particularly in small bowel, obstruction, is caused by damage to the entire thickness of the bowel wall, and predisposing factors have been identified. For each site a description of the pathogenesis, clinical findings, and present management is offered. Simple and reproducible endpoint scales for late toxicity measurement were developed and are presented for each of the three gastrointestinal organs. Factors important in analyzing late complications and future considerations in evaluation and management of radiation-related gastrointestinal injury are discussed.