Splenic irradiation for the treatment of hypersplenism from congestive splenomegaly

Kenawi, Mohamed; Elghamrawi, Kamal A.; Mohammad, AM; Kenawi, A.; El-Sadek, A. Z.

doi:10.1046/j.1365-2168.1997.02673.x

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…One possible mechanism is that irradiation leads to the release of sequestered leukocytes from the spleen. These observations align with the clinical use of splenic irradiation to alleviate leukopenia resulting from hypersplenism [ 37 , 38 ]. Another plausible explanation is that splenic irradiation may disrupt the balance between leukocyte apoptosis in the spleen and leukocyte production in the bone marrow.…”

Section: Discussionsupporting

confidence: 76%

The relationship between splenic dose and radiation-induced lymphopenia

Ma,

Kong,

Zhang

et al. 2024

Journal of Radiation Research

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Lymphocytes, which are highly sensitive to radiation, play a crucial role in the body’s defense against tumors. Radiation-induced lymphopenia has been associated with poorer outcomes in different cancer types. Despite being the largest secondary lymphoid organ, the spleen has not been officially designated as an organ at risk. This study hypothesizes a connection between spleen irradiation and lymphopenia and seeks to establish evidence-based dosage limits for the spleen. We retrospectively analyzed data from 96 patients with locally advanced gastric cancer who received postoperative chemoradiotherapy (CRT) between May 2010 and May 2017. Complete blood counts were collected before, during and after CRT. We established a model for predicting the minimum absolute lymphocyte count (Min ALC) and to investigate potential associations between spleen dosimetric variables and Min ALC. The median follow-up was 60 months. The 5-year overall survival (OS) and disease-free survival (DFS) were 65.2% and 56.8%, respectively. The median values of pre-treatment ALC, Min ALC and post-treatment ALC were 1.40 × 109, 0.23 × 109 and 0.28 × 109/L, respectively. Regression analysis confirmed that the primary tumor location, number of fractions and spleen V5 were significant predictors of Min ALC during radiation therapy. Changes in ALC (ΔALC) were identified as an independent predictor of both OS and DFS. Spleen V5 is an independent predictor for Min ALC, and the maximum dose of the spleen is associated with an increased risk of severe lymphopenia. Therefore, these doses should be restricted in clinical practice. Additionally, ΔALC can serve as a prognostic indicator for adjuvant radiotherapy in gastric cancer.

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Section: Discussionsupporting

confidence: 76%

The relationship between splenic dose and radiation-induced lymphopenia

Ma,

Kong,

Zhang

et al. 2024

Journal of Radiation Research

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“…Moreover, remission of chronic splenic pain was obtained in all patients and no significant complications were reported. 4 In 1979, Spigos et al used partial splenic artery embolization for the first time to treat hypersplenic patients with success. 5 This procedure not only increases platelet and leukocyte counts but also reduces splenic size, improves pancytopenia and stimulates the immune system.…”

Section: Discussionmentioning

confidence: 99%

Hypersplenism in a young girl: managed non-surgically

et al. 2017

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A 16-years-old female, non-alcoholic, presented with pain in left hypochondrium and distention of abdomen. Her USG Abdomen, portal vein doppler and CT abdomen revealed chronic thrombosis of intrahepatic portion of portal vein with multiple collaterals and gross splenomegaly suggestive of portal hypertension. Trans jugular liver biopsy showed no regeneration or fibrosis of liver. Endoscopy showed grade III oesophageal and gastric varices. Splenic artery embolisation was done for hypersplenism. Post procedure CT abdomen revealed large areas of splenic infarction-sequelae of splenic artery embolization.

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