Pathologic changes secondary to radiation

Abstract

In order to be effective in the treatment of disease, especially neoplastic disease, radiation necessarily needs to be given in large doses. When treating tumors with high radiosensitivity in tissue of relatively low radiosensitivity, few complications of therapy occur. Frequently, however, the differential of sensitivity to radiation between the neoplasm and normal tissues exposed is small and the incidence of radiation injury to normal tissues becomes significant. Nowhere is this more apparent than in treatment of neoplasms during which the alimentary canal is heavily radiated. The following discussion will describe the pathologic changes that occur in the various units of the exposed alimentary tract and in various components of those units during and especially months or years after radiation therapy. The usual rapid and effective regeneration of the rapid-renewal cell system after injury will be noted. The serious delayed manifestations of injury to the fibrovascular tissues with resulting delayed complications of ulcerations, stenoses, fistula formation, and obstructing adhesions will be emphasized. Brief discussions of several other organ systems injured by radiation will be presented.The development of second neoplasms as a result of radiation will be briefly mentioned and discussed from three standpoints: very low levels, low levels, and high levels of radiation.

Rebamipide alleviates radiation‐induced colitis through improvement of goblet cell differentiation in mice

“…[2][3][4] Bacterial translocation is defined as the passage of viable endogenous bacteria and endotoxins from the gastrointestinal tract to extraintestinal sites such as the mesenteric lymph node (mLN) complex, liver, spleen, kidney, and bloodstream. 5,6 Endotoxemia and bacteremia are critical events in the pathogenesis of GI-ARS, and the colon is the primary source of endotoxins, which thus highlights the importance of this tissue's injury during radiation exposure.…”

L-carnitine has a protective effect on the colonic mucosa during abdominopelvic radiotherapy in rats

“…Ionizing radiation has a cytotoxic effect on the intestinal mucosa by increasing the levels of free oxygen radicals 4,5 .…”

L-Glutamine Use in the Treatment and Prevention of Mucositis and Cachexia: A Naturopathic Perspective

“…Biochemical analysis, in vitro and in vivo, animal and human studies along with phase I-phase II human clinical trials with pilot phase III clinical trials have shown that oral GLN is a safe and effective strategy to prevent and treat mucositis, stomatitis and cachexia [2][3][4][5][6]8,11,12,[15][16][17][18][20][21][22]25,26,[29][30][31][32][33][34]38,39 (M. M. Schubert, unpublished data, 2004). Concerns about GLN being preferentially used by the cancer cells, giving a tumorprotective effect, have been addressed in the research.…”

“…2 Normal tissue damage from radiation and or chemotherapy, especially in the GI tract, influences the presence of adequate GLN stores in the tissues and can also contribute to cachexia. 4,7,18 A by-product of GLN metabolism is GSH, which protects against oxidative injury. The gut is the major site of GSH production.…”