Acute radiation proctitis: a sequential clinicopathologic study during pelvic radiotherapy

Hovdenak, Nils; Fajardo, Luis F.; Hauer‐Jensen, Martin

doi:10.1016/s0360-3016(00)00744-6

Cited by 130 publications

(87 citation statements)

References 20 publications

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“…This confirms other studies showing histopathological signs of inflammation to be more intense at week 2 of RT compared to week 6 [14] and GI toxicity symptoms to be worst at the end of RT [13,22,23]. The discrepancy in time profiles between symptoms and biopsies may be partly explained by the fact that the biopsies are from superficial layers of the bowel, while deeper tissues were not examined.…”

Section: Symptoms and Biopsiessupporting

confidence: 73%

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Time patterns of changes in biomarkers, symptoms and histopathology during pelvic radiotherapy

Larsen

Bjørge²,

Klementsen³

et al. 2007

Acta Oncologica

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Section: Symptoms and Biopsiessupporting

confidence: 73%

“…Biopsies were fixed in methanolcar-noy and formalin, paraffin embedded and sectioned for histopathology. Grading of inflammatory changes was done slightly modified from previous studies (Table I) [14]. Fibrous deposits in the basal membrane and stroma in lamina propria were visualized by staining with trichrom blue.…”

Section: Rectal Mucosal Biopsiesmentioning

confidence: 99%

Time patterns of changes in biomarkers, symptoms and histopathology during pelvic radiotherapy

Larsen

Bjørge²,

Klementsen³

et al. 2007

Acta Oncologica

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“…Rather, the effect will most likely be cumulative as shown in the acellular system used in the present study. Second, during a course of fractionated irradiation, normal tissues will generally exhibit progressive inflammation with increasing infiltration of neutrophils and macrophages from the beginning to the end of the radiation course (25,26). Similar to the findings in the present study, studies with chemical oxidation of TM have shown a significant effect of MPO (15).…”

Section: Discussionsupporting

confidence: 80%

Inactivation of Thrombomodulin by Ionizing Radiation in a Cell-Free System: Possible Implications for Radiation Responses in Vascular Endothelium

Ross¹,

MacLeod

Plaxco

et al. 2008

Radiation Research

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Background-Normal tissue radiation injury is associated with loss of vascular thromboresistance, notably because of deficient levels of endothelial thrombomodulin (TM). TM is located on the luminal surface of most endothelial cells and serves critical anticoagulant and anti-inflammatory functions. Chemical oxidation of a specific methionine residue (Met388) at the thrombin-binding site in TM reduces its main functional activity, i.e., the ability to activate protein C. We examined whether exposure to ionizing radiation affects TM in a similar manner.

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“…Hence, the number of patients with symptoms of toxicity increases steadily during a 6-week course of fractionated radiation as does the "toxicity score". However, mucosal pathology and functional bowel injury (intestinal permeability assessed with differential urinary excretion of di-/mono-saccharides) is actually substantially worse after just 2 weeks irradiation than toward the end of the treatment course 32,33 . The fact that the patient has received a 3-fold higher radiation dose at the end of the radiation therapy course than at 2 weeks, points to the remarkable regenerative capacity of the intestine and raises interesting questions of what is the real cause of the symptoms.…”

Section: Fractionated Radiation Therapy and Radiation Enteropathymentioning

confidence: 99%

Correction: Radiation enteropathy—pathogenesis, treatment and prevention

Hauer‐Jensen¹,

Denham²,

Andreyev³

2014

Nat Rev Gastroenterol Hepatol

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There has been only modest change in cancer incidence and mortality during the past several decades, but the number of cancer survivors has almost tripled during the same period. With an increasing cohort of cancer survivors, efforts to prevent, diagnose, and manage side effects of cancer therapy in general and, specifically those of radiation therapy have intensified. Many cancer survivors have undergone radiation therapy of tumors in the pelvis or abdomen, thus rendering the bowel at risk for injury. In fact, the current prevalence of patients with long term radiation-induced intestinal side effects exceeds that of ulcerative colitis and Crohn's disease combined. Significant progress toward reducing toxicity of radiation therapy has been made by the introduction of so-called dose-sculpting treatment techniques, which allow more precise delivery of the radiation beam. Moreover, new insight into the underlying pathophysiology have resulted in an improved understanding of mechanisms of radiation-induced bowel toxicity and in development of new diagnostic strategies and management opportunities. This article discusses the pathogenesis of early and delayed radiation-induced bowel toxicity, reviews current management options, and outlines priorities for future research. The gastroenterologist by adding insight into molecular and cellular mechanisms of related bowel disorders can substantially strengthen these efforts.

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Acute radiation proctitis: a sequential clinicopathologic study during pelvic radiotherapy

Cited by 130 publications

References 20 publications

Time patterns of changes in biomarkers, symptoms and histopathology during pelvic radiotherapy

Time patterns of changes in biomarkers, symptoms and histopathology during pelvic radiotherapy

Inactivation of Thrombomodulin by Ionizing Radiation in a Cell-Free System: Possible Implications for Radiation Responses in Vascular Endothelium

Correction: Radiation enteropathy—pathogenesis, treatment and prevention

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