Imaging of complications of oncological therapy in the gastrointestinal system

Abstract

Treatment of cancer involves a multidisciplinary approach consisting of surgery, chemotherapy, molecular targeted therapy and radiation therapy. These therapies work on the tumor cells to result in cell stasis or cell death. The same mechanism can result in toxicity to the normal gastrointestinal tract. Radiation therapy can cause acute and chronic injury. The chronic injury results from involvement of the vascular supply of the gastrointestinal tract and by causing fibrosis. The purpose of this article is to describe the imaging of complications resulting from oncologic treatment in the gastrointestinal system.

Preclinical evaluation of local prolonged release of paclitaxel from gelatin microspheres for the prevention of recurrence of peritoneal carcinomatosis in advanced ovarian cancer

“…This hepatoxicity can be a complication of chemotherapy as it is known that several chemotherapeutic agents have a toxic effect on the liver, inducing injuries on hepatic venous endothelium and consequently the sinusoidal obstruction syndrome. This phenomenon is most frequently described following administration of 5-fluorouracil, cyclophosphamide and oxaliplatin and is rarely seen in paclitaxel therapy 63–66 . However, elevated liver function values (bilirubin, alkaline phosphatase (ALP), aspartate and alanine aminotransferase (AST and ALT, respectively)) were reported in patients receiving IV PTX therapy, although the liver values rarely largely exceeded the upper limits of normal ALP, AST or ALT values and are dose dependent 67–73 .…”

Hyaluronic acid–doxorubicin nanoparticles for targeted treatment of colorectal cancer

“…Researchers have been looking into reducing the damage done to the intestinal cell walls from chemotherapy, as it would render the treatment more bearable and allow for a higher rate of implementation of chemotherapy. [127][128][129][130][131][132][133][134][135][136] Considering this, in our study, it is unclear whether HA-Dox induces apoptosis in the intestine due to the continuous shedding of the intestinal epithelium. As this is the most rapidly renewing tissue in the body, undergoing almost complete cellular turnover in as little as a few days, it is difficult to distinguish between normal cell death and apoptosis that is symptomatic of intestinal cancer.…”

Imaging acute complications in cancer patients: what should be evaluated in the emergency setting?

“…In addition to foreign bodies, primary neoplasias of the small intestine and colon and metastatic lesions (e.g., melanoma) can cause intussusception. When a neoplasia is suspected, care should be taken to differentiate a real tumor mass from a pseudomass caused by intussusception [ 43 - 46 ].…”

“…Acute intestinal inflammatory changes are common in patients with cancer, and various etiologies may be involved in these processes [ 46 - 48 ]. Neutropenic colitis or typhlitis is a cancer emergency that demonstrates transmural inflammation of the cecum, proximal colon, and terminal ileum [ 49 ].…”

“…Ultrasound is useful in some cases, but CT is generally the best method for the evaluation of intestinal complaints [ 37 , 40 , 46 ]. CT is also useful for excluding other causes of abdominal pain, including obstructions and inflammatory changes not associated with cancer, such as appendicitis, diverticulitis, and inflammatory bowel diseases [ 39 , 40 , 50 ].…”