Radiation-induced injury of the exocrine pancreas after chemoradiotherapy for gastric cancer

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• 作者：Jerzy Wydmanski^a ; ^{jerzywydmanski@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Pawel Polanowski^a ; ^{polanowskipawel@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Andrzej Tukiendorf^b ; ^{atukiendorf@io.gliwice.pl" class="auth_mail" title="E-mail the corresponding author} ; Barbara Maslyk^c ; ^{bmaslyk@io.gliwice.pl" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Pancreas ; Gastric cancer ; Radiotherapy ; Radiation induced pancreas injury ; Hypoamylasemia ; Hypolipasemia
• 刊名：Radiotherapy and Oncology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：118
• 期：3
• 页码：535-539
• 全文大小：568 K

文摘

The pancreas is located almost entirely within the treatment area for radiotherapy of gastric cancer. The aim of this study was to analyze radiation-induced injury of the exocrine pancreas.

Material and methods

The study included 127 gastric cancer patients, who underwent preoperative or postoperative chemoradiotherapy. A total dose of 45 Gy was given in 25 fractions. Concurrent chemotherapy was 5-fluorouracil-based. Lipase and α-amylase were assayed before, during and after treatment.

Results

Lipase and α-amylase deficiencies were found in 48.2% and 19.7% of patients, respectively. In the univariant analysis, age and pretreatment α-amylase and lipase activities influenced on risk of injury of the exocrine pancreas (p < 0.05). Younger patients (<65 years) had a lower risk of hypoamylasemia than older patients. The probability of insufficiency was lower than 0.2 for patients with pretreatment α-amylase and lipase activities above 50 U/L and 55 U/L, respectively. The multivariate analyses of the time to hypolipasemia showed that only pretreatment lipase activity was significant.

Conclusions

Gastric cancer patients have an increased risk of exocrine pancreatic insufficiency after chemoradiotherapy. Thus, the pancreas should be regarded as an OAR. Measuring lipase activity should be the standard for assessing radiation-induced pancreatic injury.