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Pathobiology, irradiation dosimetric parameters and therapy of radiation-induced gastric damage: a narrative review


McKay, MJ and Foster, R, Pathobiology, irradiation dosimetric parameters and therapy of radiation-induced gastric damage: a narrative review, Journal of Gastrointestinal Oncology, 12, (6) pp. 3115-3122. ISSN 2078-6891 (2021) [Refereed Article]

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DOI: doi:10.21037/jgo-21-361


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.

Item Details

Item Type:Refereed Article
Keywords:radiation; damage; gastric; gastritis; radiotherapy
Research Division:Biomedical and Clinical Sciences
Research Group:Oncology and carcinogenesis
Research Field:Radiation therapy
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:McKay, MJ (Professor Michael McKay)
ID Code:152447
Year Published:2021
Web of Science® Times Cited:1
Deposited By:Office of the School of Health Sciences
Deposited On:2022-08-19
Last Modified:2022-08-19

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