Acute patient-reported intestinal toxicity in whole pelvis IMRT for prostate cancer: Bowel dose-volume effect quantification in a multicentric cohort study

Bresolin, A.; Faiella, A.; Garibaldi, E.; Muñoz, Fernándo; Cante, Domenico; Vavassori, V.; Waśkiewicz, J; Girelli, G.; Avuzzi, B.; Villa, E.; Magli, A.; Chiorda, B. Noris; Gatti, Marco; Ferella, L.; Maggio, A.; Landoni, V.; Sini, C.; Rancati, T.; Sanguineti, Giuseppe; Valdagni, Riccardo; Muzio, N. Di; Fiorino, Claudio; Cozzarini, C.

doi:10.1016/j.radonc.2021.02.026

Cited by 7 publications

(3 citation statements)

References 33 publications

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“…Radiation-induced digestive injury manifests as a dosevolume effect, meaning that the extent of the lesion highly depends on the radiation dose and radiated volume (23). This theory has been verified in many studies in different organs, including the esophagus (21,24), stomach (25,26), small bowel (26,27), rectum (28)(29)(30)(31), and anus.…”

Section: B) Dose-volume Effectmentioning

confidence: 84%

Radiotherapy-Induced Digestive Injury: Diagnosis, Treatment and Mechanisms

et al. 2021

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Radiotherapy is one of the main therapeutic methods for treating cancer. The digestive system consists of the gastrointestinal tract and the accessory organs of digestion (the tongue, salivary glands, pancreas, liver and gallbladder). The digestive system is easily impaired during radiotherapy, especially in thoracic and abdominal radiotherapy. In this review, we introduce the physical classification, basic pathogenesis, clinical characteristics, predictive/diagnostic factors, and possible treatment targets of radiotherapy-induced digestive injury. Radiotherapy-induced digestive injury complies with the dose-volume effect and has a radiation-based organ correlation. Computed tomography (CT), MRI (magnetic resonance imaging), ultrasound (US) and endoscopy can help diagnose and evaluate the radiation-induced lesion level. The latest treatment approaches include improvement in radiotherapy (such as shielding, hydrogel spacers and dose distribution), stem cell transplantation and drug administration. Gut microbiota modulation may become a novel approach to relieving radiogenic gastrointestinal syndrome. Finally, we summarized the possible mechanisms involved in treatment, but they remain varied. Radionuclide-labeled targeting molecules (RLTMs) are promising for more precise radiotherapy. These advances contribute to our understanding of the assessment and treatment of radiation-induced digestive injury.

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Section: B) Dose-volume Effectmentioning

confidence: 84%

Radiotherapy-Induced Digestive Injury: Diagnosis, Treatment and Mechanisms

et al. 2021

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“…The effects of radiation also depend on how much the body is exposed to it. The radiation-induced gastrointestinal injury appears to be a dose-volume effect, meaning that the extent of the lesion is highly dependent on radiation dose and radiation volume [127]. When radiation is beamed to a small region, as in radiation therapy for cancer, it can be administered up to three or four times without seriously harming the body [128].…”

Section: The Effect Of Radiation On the Gastrointestinal Tractmentioning

confidence: 99%

Health Effects of Ionizing Radiation on the Human Body

Talapko,

Katalinić

et al. 2024

Medicina

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Radioactivity is a process in which the nuclei of unstable atoms spontaneously decay, producing other nuclei and releasing energy in the form of ionizing radiation in the form of alpha (α) and beta (β) particles as well as the emission of gamma (γ) electromagnetic waves. People may be exposed to radiation in various forms, as casualties of nuclear accidents, workers in power plants, or while working and using different radiation sources in medicine and health care. Acute radiation syndrome (ARS) occurs in subjects exposed to a very high dose of radiation in a very short period of time. Each form of radiation has a unique pathophysiological effect. Unfortunately, higher organisms—human beings—in the course of evolution have not acquired receptors for the direct “capture” of radiation energy, which is transferred at the level of DNA, cells, tissues, and organs. Radiation in biological systems depends on the amount of absorbed energy and its spatial distribution, particularly depending on the linear energy transfer (LET). Photon radiation with low LET leads to homogeneous energy deposition in the entire tissue volume. On the other hand, radiation with a high LET produces a fast Bragg peak, which generates a low input dose, whereby the penetration depth into the tissue increases with the radiation energy. The consequences are mutations, apoptosis, the development of cancer, and cell death. The most sensitive cells are those that divide intensively—bone marrow cells, digestive tract cells, reproductive cells, and skin cells. The health care system and the public should raise awareness of the consequences of ionizing radiation. Therefore, our aim is to identify the consequences of ARS taking into account radiation damage to the respiratory system, nervous system, hematopoietic system, gastrointestinal tract, and skin.

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“…For instance, D25 = 40 means that 40% of that organ receives 25 Gy of radiation. The extent of radiation injury depends on the radiation dose, and the volume of tissue irradiated [ 26 ].…”

Section: Pathogenesis Of Radiation Injury To the Gitmentioning

confidence: 99%

Radiation in Gastroenterology

Ahmed

2022

Gastroenterol Res

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The benefit of radiation is immense in the field of gastroenterology. Radiation is used daily in different gastrointestinal imaging and diagnostic and therapeutic interventional procedures. Radiotherapy is one of the primary modalities of treatment of gastrointestinal malignancies. There are various modalities of radiotherapy. Radiotherapy can injure malignant cells by directly damaging DNA, RNA, proteins, and lipids and indirectly by forming free radicals. External beam radiation, internal beam radiation and radio-isotope therapy are the major ways of delivering radiation to the malignant tissue. Radiation can also cause inflammation, fibrosis, organ dysfunction, and malignancy. Patients with repeated exposure to radiation for diagnostic imaging and therapeutic procedures are at slightly increased risk of malignancy. Gastrointestinal endoscopists performing fluoroscopy-guided procedures are also at increased risk of malignancy and cataract formation. The radiological protection society recommends certain preventive and protective measures to avoid side effects of radiation. Gastrointestinal complications related to radiation therapy for oncologic processes, and exposure risks for patients and health care providers involved in diagnostic or therapeutic imaging will be discussed in this review.

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Acute patient-reported intestinal toxicity in whole pelvis IMRT for prostate cancer: Bowel dose-volume effect quantification in a multicentric cohort study

Cited by 7 publications

References 33 publications

Radiotherapy-Induced Digestive Injury: Diagnosis, Treatment and Mechanisms

Radiotherapy-Induced Digestive Injury: Diagnosis, Treatment and Mechanisms

Health Effects of Ionizing Radiation on the Human Body

Radiation in Gastroenterology

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