Pathologic effects of fractionated fast neutrons or photons on the pancreas, pylorus and duodenum of dogs

Zook, Bernard C.; Bradley, Edward C.; Casarett, George W.; Rogers, Charles C.

doi:10.1016/0360-3016(83)90324-3

Cited by 15 publications

(9 citation statements)

References 25 publications

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“…As a summary of these animal and human studies mentioned above [5][6][7][19][20][21][22][23][24][25][26], there is relative sensitivity of the exocrine part of the pancreas to irradiation in comparison to the endocrine part of the organ. Vascular damage is the most common cause of radiation toxicity [5][6][7][19][20][21][22][23][24][25][26].…”

Section: Discussionmentioning

confidence: 96%

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Risk of endocrine pancreatic insufficiency in patients receiving adjuvant chemoradiation for resected gastric cancer

Gemici

Sargın

Uygur-Bayramiçli

et al. 2013

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 96%

“…Acinar cells of the pancreas are much more sensitive to radiation damage than islet cells and the pathophysiology of radiation damage is mainly due to chronic vascular injury with eventual fibrosis and atrophy of the gland [5][6][7][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Risk of endocrine pancreatic insufficiency in patients receiving adjuvant chemoradiation for resected gastric cancer

Gemici

Sargın

Uygur-Bayramiçli

et al. 2013

Radiotherapy and Oncology

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“…The relatively lower plasma PABA levels at 90 and 135 days may be attributed to decreased acinar cell mass resulting from radiation damage to blood vessels and ducts. 6 The 135-day mean plasma PABA levels were the lowest in the irradiated groups ( Table 2). The mean plasma PABA levels in irradiated groups at this time were significantly lower than the presurgical levels (P < 0.005).…”

mentioning

confidence: 92%

“…Clinical exocrine pancreatic insufficiency was not observed up to 135 days postoperatively in dogs that survived but the data indicated progressive decrease in exocrine pancreNo. 6 INTRAOPERATIVE PANCREAS IRRADIATION -Ahmadu-Suka et al 1095 atic function due to decreased acinar cell mass. One dog that received 25 Gy developed typical signs of exocrine pancreatic insufficiency and died 122 days postoperatively.…”

mentioning

confidence: 99%

Exocrine pancreatic function following intraoperative irradiation of the canine pancreas

Ahmadu-Suka¹,

Gillette²,

Withrow³

et al. 1988

Cancer

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Twenty-four beagles received intraoperative irradiation (IORT) with 6 meV electrons to the pancreas and the duodenum. Intraoperative irradiation doses of 17.5 to 40 Gy were given. Billroth I1 gastrojejunostomy was done to bypass the irradiated duodenum. Six control dogs received only the Billroth I1 surgery. Two weeks postoperatively, irradiated dogs were given 50 Gy of 6 MV X radiation (externalbeam radiation [EBRTJ) to the pancreas and duodenum in 2 Gy fractions over a 5-week period. Dogs were monitored clinically and exocrine pancreatic function was evaluated using an N-benzoyl-l-tyrosylpara-aminobenzoic acid (BT-PABA) test between 3 and 135 days postoperatively. Necropsies were performed on the dogs at 135 days postoperatively. The degree of gross pancreatic atrophy in the irradiated group was dose related. The mean percentage of normal acinar cells correlated with IORT doses and para-aminobenzoic acid (PABA) values (P < 0.1). Weight loss was significantly greater in the irradiated dogs compared to the control (P < 0.05) and the mean percentage of body weight loss correlated with the mean PABA values (P < 0.01). In this study, the use of the BT-PABA test to evaluate progressive exocrine pancreatic function following IORT and EBRT showed an expected trend. A progressive decrease in exocrine pancreatic function in the irradiated dogs as indicated by plasma PABA levels may have been partly due to late radiation damage to acinar cells, secondary to vascular and ductular damage. At 135 days postoperatively none of the dogs showed clinical signs of exocrine pancreatic insufficiency and the plasma PABA levels were within the normal presurgical range. The progressive decrease in plasma PABA levels indicated a potential for the late development of exocrine pancreatic insufficiency. The BT-PABA test could be useful for evaluating the progressive decrease in exocrine pancreatic function and residual radiation injury to the pancreas. Because the exocrine deficiency can be managed with replacement therapy, pancreatic injury may not be a serious complication after doses of less than 30 Gy IORT with 50 Gy EBRT. Data from this study are in agreement with previous clinical and experimental reports that the duodenum is dose-limiting for IORT. Doses of 20 Gy IORT or less plus 50 Gy EBRT for treatment of carcinoma of the pancreas may not result in serious long-term complications due to radiation injury of the duodenum.Cancer 62:1091-1095, 1988.NTRAOPERATIVE RADIOTHERAPY (IORT) for pancre-I atic adenocarcinoma is considered to be one of the most promising treatment modalities for this fatal disReports from several centers have indicated that the use of IORT for pancreatic adenocarcinoma increased the median survival time of patients as well as alleviated pain associated with this disease. The duodenum is considered to be dose-limiting in IORT for pancreatic adenocar~inoma.~ Intraoperative radiotherapy doses in excess of 20 Gy resulted in duodenal ~lceration.~ Duodenal fibroses and stenosis commonly occurred after IORT and for th...

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“…The acinar cells of the pancreas are relatively sensitive to radiation and this finding has been described clearly after RT findings. 18 In some studies, chronic pancreatitis was reported years after abdominal RT. 19 In our study, exposure of pancreas to radiation decreases plasma amylase levels.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Chemoradiotherapy at Gastric Cancer on Pancreatic Enzymes and Pancreas Volume.

Kandaz¹

2017

UHOD

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Post-operative chemoradiotherapy is one of the therapeutic approaches for operated gastric cancer. During radiotherapy planning, pancreas has not been accepted as a critical organ until now, thus toxicity to pancreas has not been considered. In our prospective study, serum pancreatic enzyme levels and pancreatic volume after RT is investigated. Seventy-one patients with gastric cancer were evaluated adjuvant chemoradiotherapy. Mean pancreas volume, mean pancreas radiotherapy dose and V5, V10, V20 and V40 values were calculated. Fasting blood glucose, insulin, amylase and glycosylated hemoglobin levels were evaluated before radiotherapy and re-evaluated at the end of radiotherapy, at 1th, 3rd, 6th and 12th months after radiotherapy. Pancreas volume was evaluated before radiotherapy and re-evaluated at 12th month after radiotherapy. Before the initiation, after the first session and at the 1th, 3th, 6th and 12th months of radiotherapy, difference between serum Fasting blood glucose (p= 0.179), insulin (p= 0.296), HbA1c (p= 0.468) and amylase levels (p= 0.069) levels were not statistically significant but there is statistically significant decrease in pancreatic volume after treatment (p= 0.002). Postoperative chemoradiotherapy is able to prolong survival and decrease recurrence in operated gastric cancer patients. In our prospective study, we could not identify any statistically significant finding related to pancreatic toxicity or its presentation on biochemical parameters except pancreas atrophy in one-year period. Although, there was not any self-reported diabetes mellitus at early period it, follow-up needed for late toxicity. Keywords: Chemoradiotherapy, Gastric cancer, Pancreatic enzymes, Pancreas volume ÖZET Mide Kanserinde Kemoradyoterapinin Pankreas Hacmi ve Pankreas Enzimleri Üzerine EtkisiPost-operatif kemoradyoterapi, ameliyat edilen mide kanseri için terapötik yaklaşımlardan biridir. Radyoterapi planlaması sırasında şimdiye kadar pankreas kritik bir organ olarak kabul edilmemiştir, bu nedenle pankreas toksisitesi dikkate alınmamıştır. Prospektif çalışmamızda, radyoterapi sonrası serum pankreatik enzim düzeyleri ve pankreas hacmi araştırılmıştır. Adjuvan kemoradyoterapi uygulanan 71 mide kanserli hasta değerlendirildi. Ortalama pankreas hacmi, ortalama pankreas radyoterapi dozu ve V5, V10, V20 ve V40 değerleri hesaplandı. Açlık kan şekeri, insülin, amilaz ve glikolize hemoglobin düzeyleri radyoterapi öncesi değerlendirildi ve radyoterapi bitiminde, radyoterapiden sonra 1, 3, 6. ve 12. aylarda yeniden değerlendirildi. Pankreas hacmi radyoterapi öncesi değerlendirildi ve radyoterapiden sonraki 12. ayda yeniden değerlendirildi. Radyoterapi öncesi, radyoterapi bitiminde, radyoterapiden sonra 1, 3, 6. ve 12. aylarda serum açlık kan glikozu (p= 0.179), insülin (p= 0.296), HbA1c (p= 0.468) ve amilaz düzeyleri istatistiksel olarak anlamlı değildi (p= 0.069), ancak tedavi sonrası pankreas hacminde istatistiksel olarak anlamlı bir azalma vardı (p= 0.002). Postoperatif kemoradyoterapi ameliyat edilen mide...

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Pathologic effects of fractionated fast neutrons or photons on the pancreas, pylorus and duodenum of dogs

Cited by 15 publications

References 25 publications

Risk of endocrine pancreatic insufficiency in patients receiving adjuvant chemoradiation for resected gastric cancer

Risk of endocrine pancreatic insufficiency in patients receiving adjuvant chemoradiation for resected gastric cancer

Exocrine pancreatic function following intraoperative irradiation of the canine pancreas

The Effect of Chemoradiotherapy at Gastric Cancer on Pancreatic Enzymes and Pancreas Volume.

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