Gastrointestinal toxicity associated to radiation therapy

Rodríguez, Mario López; Martín, Marta; Cerezo, Laura; Palomo, Alicia Marín; Puebla, Yamile Ibáñez

doi:10.1007/s12094-010-0553-1

Cited by 28 publications

(13 citation statements)

References 104 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…70 Radiation dose ≥30 Gy (inclusive of any TBI) is a risk factor for stricture formation. 70;71 Additional risk factors for esophageal stricture specifically include chronic GVHD, prior candida esophagitis, and gastroesophageal reflux. 70;72 Late bowel obstruction can be seen many years after abdominal surgery.…”

Section: Gastrointestinalmentioning

confidence: 99%

Late Effects Surveillance Recommendations among Survivors of Childhood Hematopoietic Cell Transplantation: A Children's Oncology Group Report

Chow

Anderson

Baker

et al. 2016

Biology of Blood and Marrow Transplantation

173

152

View full text Add to dashboard Cite

Hematopoietic cell transplantation (HCT) is an important curative treatment for children with high-risk hematologic malignancies and solid tumors, and increasingly, non-malignant diseases. Given improvements in care, there is a growing number of long-term survivors of pediatric HCT. Compared with non-transplanted childhood cancer survivors, HCT survivors have been shown to have a substantially increased burden of serious chronic conditions and impairments involving virtually every organ system and overall quality of life. This likely reflects the joint contributions of pre-transplant treatment exposures and organ dysfunction, the transplant conditioning regimen, and any post-transplant graft versus host disease (GVHD). In response, the Children’s Oncology Group (COG) has created Long-Term Follow-Up Guidelines (www.survivorshipguidelines.org) for survivors of childhood, adolescent, and young adult cancer, including those treated with HCT. Guidelines taskforces, consisting of HCT specialists, other pediatric oncologists, radiation oncologists, organ-specific subspecialists, nurses, social workers, other healthcare professionals, and patient advocates have systematically reviewed the literature with regards to late effects after childhood cancer and HCT since 2002, with the most recent review completed in 2013. For the most recent review cycle, over 800 articles from the medical literature relevant to childhood cancer and HCT survivorship were reviewed, including 586 original research articles. Provided here-in is an organ system-based overview that emphasizes the most relevant COG recommendations (with accompanying evidence grade) for the long-term follow-up care of childhood HCT survivors (regardless of current age) based on a rigorous review of the available evidence. These recommendations cover both autologous and allogeneic HCT survivors, those transplanted for non-malignant diseases, and those with a history of chronic GVHD.

show abstract

Section: Gastrointestinalmentioning

confidence: 99%

Late Effects Surveillance Recommendations among Survivors of Childhood Hematopoietic Cell Transplantation: A Children's Oncology Group Report

Chow

Anderson

Baker

et al. 2016

Biology of Blood and Marrow Transplantation

173

152

View full text Add to dashboard Cite

show abstract

“…Importantly, radiation therapy remains a mainstay in the management of cancer, a leading cause of death worldwide. Radiation therapy destroys rapidly proliferating cancer cells and, inevitably, normal tissues characterized by continuous regeneration programs, including hair follicles, bone marrow, the GI tract as well as other glandular epithelia (5). In that context, dose-limiting toxicities of radiation discourage patients from completing therapy; restrict maximum doses of radiation which limits the efficacy of treatment; and can lead to chronic morbidity and mortality (5).…”

Section: Introductionmentioning

confidence: 99%

GUCY2C Signaling Opposes the Acute Radiation-Induced GI Syndrome

et al. 2017

View full text Add to dashboard Cite

High doses of ionizing radiation induce acute damage to epithelial cells of the gastrointestinal (GI) tract, mediating toxicities restricting the therapeutic efficacy of radiation in cancer and morbidity and mortality in nuclear disasters. No approved prophylaxis or therapy exists for these toxicities, in part reflecting an incomplete understanding of mechanisms contributing to the acute radiation-induced GI syndrome (RIGS). Guanylate cyclase C (GUCY2C) and its hormones guanylin and uroguanylin have recently emerged as one paracrine axis defending intestinal mucosal integrity against mutational, chemical, and inflammatory injury. Here, we reveal a role for the GUCY2C paracrine axis in compensatory mechanisms opposing RIGS. Eliminating GUCY2C signaling exacerbated RIGS, amplifying radiation-induced mortality, weight loss, mucosal bleeding, debilitation and intestinal dysfunction. Durable expression of GUCY2C, guanylin and uroguanylin mRNA and protein by intestinal epithelial cells was preserved following lethal irradiation inducing RIGS. Oral delivery of the heat-stable enterotoxin (ST), an exogenous GUCY2C ligand, opposed RIGS, a process requiring p53 activation mediated by dissociation from MDM2. In turn, p53 activation prevented cell death by selectively limiting mitotic catastrophe, but not apoptosis. These studies reveal a role for the GUCY2C paracrine hormone axis as a novel compensatory mechanism opposing RIGS, and they highlight the potential of oral GUCY2C agonists (Linzess™; Trulance™) to prevent and treat RIGS in cancer therapy and nuclear disasters.

show abstract

“…4,5 The mechanism is believed to be primarily an increased delivery of O 2 up to the injured intestinal tissue to promote faster healing, enhance immunity, and prevent colonization of harmful bacteria. 13 Albenberg et al demonstrated convincingly that hyperbaric O 2 therapy also alters the host mucosal bacterial communities and may provide further protection against pathogenesis by potential pathobionts in the gut. More research is needed to assess the functional role of hyperbaric O 2 -induced microbiota and whether this therapy may be beneficial in the co-management of patients with chronic intestinal inflammation or injury.…”

mentioning

confidence: 99%