Advertisement

Radiation Injury

  • H. A. Vuilleumier
  • E. D. Reis
Chapter

Abstract

Deleterious effects of radiation on normal tissues were recognized soon after Roentgen’s original publication on “A New Kind of Ray” in 1885 [65]. Rowland [66] reported a case of actinic dermatitis in 1896 and Walsh [78] reported gastrointestinal toxicity in 1887. Thereafter, radiation-related damage to all organs has been described and extensively studied. Despite the evolution of radiotherapy into a more powerful, accurate, and safer tool for tumor control, radiation injury remains its most important limiting factor. In fact, as this modality gained broader applications, a parallel increase in the number of patients with radiation-induced complications has been seen [1,50].

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Allen-Mersh TG, Wilson EJ, Hope-Stone HF,Mann CV (1986) Has the incidence of radiation-induced bowel damage following treatment of uterine carcinoma changed in the last 20 years? J R Soc Med 79 (7):387–390PubMedCentralPubMedGoogle Scholar
  2. 2.
    Anonymous (1984) Radiation bowel disease. Lancet (Oct) ii:963–964Google Scholar
  3. 3.
    Berry RJ (1966) Effects of some metabolic inhibitors on x-ray dose-response curves for the survival of mammalian cells in vitro, and on early recovery between fractionated x-ray doses. Br J Radiol 39:458–463PubMedCrossRefGoogle Scholar
  4. 4.
    Bricker EM, Johnston WD (1979) Repair of postirradiation rectovaginal fistula and stricture. Surg Gynecol Obstet 148:499–506PubMedGoogle Scholar
  5. 5.
    Bricker EM, Kraybill WG, Lopez MJ (1986) Functional results after postirradiation rectal reconstruction. World J Surg 10:248–258Google Scholar
  6. 6.
    Boronow RC (1986) Repair of the radiation induced vaginal fistula utilizing the Martius technique. World J Surg 10:237–248PubMedCrossRefGoogle Scholar
  7. 7.
    Busch DB (1990) Pathology of the radiation-damaged bowel. In: Galland RB, Spencer J (eds) Radiation enteritis. Arnold, London, pp 66–87Google Scholar
  8. 8.
    Carr ND, Pullen BR, Hasleton PS, Schofield PF (1984) Microvascular studies in human radiation bowel disease. Gut 25:448–454PubMedCrossRefGoogle Scholar
  9. 9.
    Carrol MP, Zera RT, Roberts JC, Schlafmann SE, Feeney DA, Johnston GR, West MA, Bubrick MP (1995) Efficacy of radioprotective agents in preventing small and large bowel radia-tion injury. Dis Colon Rectum 38:716–722CrossRefGoogle Scholar
  10. 10.
    Catalona WJ, Scott WW (1986) Carcinoma of the prostate. In: Walsh PC, Gitte RF, Perlmutter AD, Stamey TA (eds) Campbell’s urology. Saunders, Philadelphia, pp 1463–1534Google Scholar
  11. 11.
    Chen PW, Sindelar WF (1996) Intestinal complications of radiation therapy. In: Lefor AT (ed) Surgical problems affecting the patient with cancer: Interdisciplinary management. Lippincott-Raven, Philadelphia, pp 143–160Google Scholar
  12. 12.
    Coia LR, Myerson RJ, Tepper JE (1995) Late effects of radiation therapy on the gastrointestinal tract. Int J Radiat Oncol Biol Phys 31(5):1213–1236PubMedCrossRefGoogle Scholar
  13. 13.
    Cox JD, Guse C, Asbell S, Rubin P, Sause WT (1988) Tolerance of pelvic normal tissues to hyperfractionated radiation therapy: results of Protocol 83–08 of the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 15:1331–1336PubMedCrossRefGoogle Scholar
  14. 14.
    Cox JD, Stetz J, Pajak TF (1995) Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 31:1341–1346PubMedCrossRefGoogle Scholar
  15. 15.
    DeCosse JJ (1991) Radiation injury to the intestine. In: Sabis-ton DC (ed) Textbook of surgery. Saunders, Philadelphia, pp 880–884Google Scholar
  16. 16.
    DeCosse JJ, Rhodes RS, Wentz WB, Reagan JW, Dworken HJ, Holden WD (1969) The natural history and management of radiation-induced injury of the gastrointestinal tract. Ann Surg 170:369–384PubMedCrossRefGoogle Scholar
  17. 17.
    Dische S, Warburton MF, Jones D, Lartique E (1989) The recording of morbidity related to radiotherapy. Radiother Oncol 16:103–108PubMedCrossRefGoogle Scholar
  18. 18.
    Duncan W, Leonard JC (1965) The malabsorption syndrome following radiotherapy. Q J Med 34 319–329PubMedGoogle Scholar
  19. 19.
    EORTC/RTOG Working Groups (1995) LENT SOMA scales for anatomic sites. Int J Radiat Oncol Biol Phys 31:1072–1091Google Scholar
  20. 20.
    Feldmeier JJ, Jelen I, Davolt DA, Valente PT, Meltz ML, Alecu R (1995) Hyperbaric oxygen as a prophylaxis for radiation-induced delayed enteropathy. Radiother Oncol 35:138–144PubMedCrossRefGoogle Scholar
  21. 21.
    Felemovicius I, Bonsack ME, Baptista ML, Delaney JP (1995) Intestinal radioprotection by vitamin E (alpha-tocopherol). Ann Surg 222:508–510Google Scholar
  22. 22.
    Fair WR, Fuks ZY, Scher HI (1993) Cancer of the bladder. In: DeVita VT, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology. Lippincott, Philadelphia, pp 1052–1072Google Scholar
  23. 23.
    Fine BA, Hempling RE, Piver MS, Baker TR, McAuley M, Driscoll D (1995) Severe radiation morbidity in carcinoma of the cervix: impact of pretherapy surgical staging and previous surgery. Int J Radiat Oncol Biol Phys 31:717–723PubMedCrossRefGoogle Scholar
  24. 24.
    Gallagher MJ, Brereton HD, Rostock RA, Zero JM, Zekoski JA, Poyss LF, Richtre MP, Kligerman MM (1986) A prospective study of treatment techniques to minimize the volume of pelvic small bowel with reduction of acute and late effects associated with pelvic irradiation. Int J Radiat Oncol Biol Phys 12:1565–1573PubMedCrossRefGoogle Scholar
  25. 25.
    Gary-Bobo J, Pujol H, Solassol C, Broquerie JL, Nguyen M (1979) L’irradiation preoperatoire du cancer rectal. Resultats ä 5 ans de 116 cas. Bull Cancer (Paris) 66:491–496Google Scholar
  26. 26.
    Gelfand MD, Tepper M, Katz LA, Binder HJ, Yerner R, Floch MH (1968) Acute irradiation proctitis in man. Gastroenterology 54:401PubMedGoogle Scholar
  27. 27.
    Gèrard A, Berrod JL, Pène F et al (1985) Interim analysis of a phase III study on preoperative radiation therapy in resectable rectal carcinoma: trial of the gastrointestinal tract can-cer cooperative group of the European Organization for Research on Treatment of Cancer (EORTC). Cancer 55:2373–2379PubMedCrossRefGoogle Scholar
  28. 28.
    Goligher J (1984) Irradiation proctitis and enteritis. In: Goligher J (ed) Surgery of the anus, rectum and colon. Bailliere Tindall, London, pp 1047–1057Google Scholar
  29. 29.
    Gray MJ, Kottmeier Gl (1957) Rectal and bladder injuries following radium therapy for carcinoma of the cervix at the Radiumhemmet. Am J Obstet Gynecol 74:1294–1303PubMedGoogle Scholar
  30. 30.
    Gunderson LL, Martin JK, Beart RW (1988) Intraoperative and external beam irradiation for locally advanced colo-rec-tal cancer. Ann Surg 207:52–60PubMedCrossRefGoogle Scholar
  31. 31.
    Hanks GE, Schultheiss TE, Hunt MA, Epstein B (1995) Factors influencing incidence of acute grade 2 morbidity in conformal and standard radiation treatment of prostate cancer. Int J Radiat Oncol Biol Phys 31:25–29PubMedCrossRefGoogle Scholar
  32. 32.
    Harrison M, Tomlinson D, Stewart S, et al (1995) Squamous cell carcinoma of the anus in patients with AIDS. Clin Oncol 7(1):50–51CrossRefGoogle Scholar
  33. 33.
    Hellman S (1993) Principles of radiation therapy. In: DeVita VT, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology, 4th edn. Lippincott, Philadelphia, pp 248–275Google Scholar
  34. 34.
    Hintz B, Kagan A, Chan P, Gilbert H, Nussbaum G, Rao A, Wollin M (1980) Radiation tolerance of the vaginal mucosa. Int J Radiat Oncol Biol Phys 6:711–716PubMedCrossRefGoogle Scholar
  35. 35.
    Hughes EP, Veidenheimer MC, Corman ML, Coller JA (1982) Electrocoagulation of rectal cancer. Dis Colon Rectum 25:215–218PubMedCrossRefGoogle Scholar
  36. 36.
    Ingelman-Sundberg A (1969) Pathogenesis and operative treatment of urinary tract fistulae in irradiated tissue. In: Youssef AF (ed) Gynaecologic urology. Thomas, Springfield, pp 263–279Google Scholar
  37. 37.
    Kimose HH, Fischer L, Spjeldnaes N, Wara P (1989) Late radiation injury of the colon and rectum. Surgical management and outcome. Dis Colon Rectum 32:684–689PubMedCrossRefGoogle Scholar
  38. 38.
    Kinsela TJ, Bloomer WD (1980) Bowel tolerance to radiation therapy. Surg Gynecol Obstet 151:273–284Google Scholar
  39. 39.
    Kligerman MM, Urdaneta N, Knowlton A, Vidone R, Hart-man PV, Vera R (1972) Preoperative irradiation of rectosigmoid carcinoma including its regional lymph nodes. AJR 114:498–503CrossRefGoogle Scholar
  40. 40.
    Lawton CA, Won M, Pilepich MV et al (1991) Long-term treatment sequelae following external beam irradiation for adenocarcinoma of the prostate: analysis of RTOG studies 7506 and 7706. Int J Radiat Oncol Phys 21:935–939CrossRefGoogle Scholar
  41. 41.
    Letschert JGJ, Lebesque JV, DeBoer RW, Hart A AM, Bartelink H (1990) Dose-volume correlation in radiation-related late small bowel complications: a clinical study. Radiother Oncol 18:307–320PubMedCrossRefGoogle Scholar
  42. 42.
    Letschert JGJ, Lebesque JV, Aleman BMP, Bosset JF, Horiot JC, Bartelink H, Cionini L, Hamers JP, Leer JWH, van Glabbeke M (1994) The volume effect in radiation-related small bowel complications: results of a clinical study of the EORTC Radiotherapy Cooperative Group in patients treated for rectal carcinoma. Radiother Oncol 32:116–123PubMedCrossRefGoogle Scholar
  43. 43.
    Levi S, Hodgson HJ (1990) Prevention of radiation enteritis. In: Galland RB, Spencer J (eds) Radiation enteritis. Arnold, London, pp 120–135Google Scholar
  44. 44.
    Loiudice T, Baxter D, Balint J (1977) Effects of abdominal surgery on the development of radiation enteropathy. Gastroenterology 73:1903Google Scholar
  45. 45.
    Maingon P, Horiot JC, Fraisse J, Salas S, Collin F, Bone-Lepi-noy MC, Barillot I, Douvier S, Padeano MM, Cuisenier J (1996) Preoperative radiotherapy in stage I/II endometrial adenocarcinoma. Radiother Oncol 39:201–208PubMedCrossRefGoogle Scholar
  46. 46.
    McArdle AH (1994) Protection from radiation injury by elemental diet: does added glutamine change the effect? Gut [Suppl] 1:S60-S64CrossRefGoogle Scholar
  47. 47.
    McCall ML, Bolter KA (eds/transls) (1959) Martius’gynecological operations: with emphasis on topographic anatomy. Little Brown, Boston, pp 322–333Google Scholar
  48. 48.
    Mettlin CJ, Murphy GP, Ho R, Menck HR (1996) The national cancer data base report on longitudinal observations on prostate cancer. Cancer 77:2162–2166PubMedCrossRefGoogle Scholar
  49. 49.
    Michalowski AS (1994) On radiation damage to normal tissues and its treatment. II. Anti-inflammatory drugs. Acta Oncol 33 (2):139–157PubMedCrossRefGoogle Scholar
  50. 50.
    Morgenstern L, Hart M, Lugo D, Friedman NB (1985) Changing aspects of radiation enteropathy. Arch Surg 120 (11):1255–1258CrossRefGoogle Scholar
  51. 51.
    MRC Working Party (1982) A trial of preoperative radiotherapy in the management of operable rectal cancer. Br J Surg 69:513–519CrossRefGoogle Scholar
  52. 52.
    Nagata H (1980) Studies on sulfhydryl radioprotectors with low toxicity. Tokushima J Exp Med 27:15PubMedGoogle Scholar
  53. 53.
    O’Connell D, Howard N, Joslin CA, Ramsey NW, Liversage WE (1965) A new remotely controlled unit for the treatment of uterine cancer. Lancet ii:570–571Google Scholar
  54. 54.
    O’Conner JJ (1989) Argon laser treatment of hemorrhagic radiation proctitis. Arch Surg 124:749CrossRefGoogle Scholar
  55. 55.
    Orton GC (1995) Width of the therapeutic window: what is the optimal dose-per-fraction for high dose rate cervix cancer brachytherapy? Int J Radiat Oncol Biol Phys 31:1011–1013PubMedCrossRefGoogle Scholar
  56. 56.
    Ottosen C, Simonsen E (1994) The use of an absorbable mesh to avoid radiation-associated small-bowel injury in the treatment of gynaecological malignancy. Acta Oncol 33:703–705PubMedCrossRefGoogle Scholar
  57. 57.
    Papillon J (1982) Rectal and anal cancers. Conservative treatment by irradiation — an alternative to radical surgery. Springer, Berlin Heidelberg New YorkGoogle Scholar
  58. 58.
    Parks AG, Allen CLO, Frank JD, McPartlin JF (1978) A method of treating postirradiation rectovaginal fistulas. Br J Surg 65:417–421PubMedCrossRefGoogle Scholar
  59. 59.
    Perez CA,Di Saia PJ, Knapp RD (1985) Gynecologic tumors. In: DeVita VT, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology. Lippincott, Philadelphia pp 1013–1081Google Scholar
  60. 60.
    Perez CA, Camel HM, Galakatos AE, Grigsby PW, Kuske R, Buchsbaum G, Hederman M (1988) Definitive irradiation in carcinoma of the vagina: long-term evaluation of results. Int J Radiat Oncol Biol Phys 15:1283–1290PubMedCrossRefGoogle Scholar
  61. 61.
    Phillips TL, Fu KK (1976) Quantification of combined radiation therapy and chemotherapy effects on critical normal tissue. Cancer 37 1186PubMedCrossRefGoogle Scholar
  62. 62.
    Rider WD, Palmer JA, Mahoney LJ, Robertson CT (1977) Pre-operative irradiation in operable cancer of the rectum: report of the Toronto trial. Can Surg 20:335–833Google Scholar
  63. 63.
    Roche B, Chautems R, Marti MC (1996) Application of formaldehyde for treatment of hemorrhagic radiatio-induced proctitis. World J Surg 20:1092–109PubMedCrossRefGoogle Scholar
  64. 64.
    Rodemann HP, Bamberg M (1995) Cellular basis of radiation-induced fibrosis. Radiat Oncol 35:83–90Google Scholar
  65. 65.
    Roentgen WC (1945) On a new kind of ray (translation). Radiology 45:428–435Google Scholar
  66. 66.
    Rowland S (1896) Report on the action the new photography to medicine and surgery. Br Med J 1:997–998PubMedCentralCrossRefGoogle Scholar
  67. 67.
    Rowsit B, Higgins GA, Humphrey EW, Rubinette CD (1973) Preoperative irradiation of operative adenocarcinoma of the rectum and rectosigmoid colon. Radiology 108:389–395Google Scholar
  68. 68.
    RTOG/EORTC (1995) Joint statement of mission by the RTOG/EORTC working groups. Int J Radiat Oncol Biol Phys 31:1037–1039CrossRefGoogle Scholar
  69. 69.
    Rubin P, Casarett GW (1986) The female genital tract. In: Rubin P, Casarett GW (eds) Clinical radiation pathology. Saunders, Philadelphia, pp 396–422Google Scholar
  70. 70.
    Rubin P, Constine LS, Van Ess J (1988) Late effects of toxicity scoring. Natl Cancer Inst Monogr 6:9–18Google Scholar
  71. 71.
    See WA, Dreicer R, Wheeler JA, Forest PK, Loening S (1996) Brachytherapy and continuous infusion 5-fluorouracil for the treatment of locally advanced, lymph node negative, prostate cancer. Cancer 77:924–927PubMedCrossRefGoogle Scholar
  72. 72.
    Shaw MT, Spector MH, Ladman AJ (1979) Effects of cancer radiotherapy, and cytotoxic drugs on intestinal structure and function. Cancer Treat Rev 6:141PubMedCrossRefGoogle Scholar
  73. 73.
    Strockbine MF, Hancock JE, Fletcher GH (1970) Complications in patients with squamous cell carcinoma of the intact uterine cervix treated with 3000 rad or more whole pelvis irradiation. Am J Roentgenol 108:293–304CrossRefGoogle Scholar
  74. 74.
    Touboul E (1995) Epidermoid carcinoma of the anal margin: 17 cases treated with curative-intent radiation therapy. Ra-diother Oncol 34 (3):195–202CrossRefGoogle Scholar
  75. 75.
    Varma JS, Smith AN, Busuttil A (1998) Function of the anal sphincters after chronic radiation injury. Gut 27:528–33CrossRefGoogle Scholar
  76. 76.
    Vasilev SA, McGonigle KF, Spencer-Smith EL (1995) Intestinal peritoneal sling as an adjunct to radical pelvic operation and pelvic irradiation. J Am Coll Surg 180:568–572PubMedGoogle Scholar
  77. 77.
    Vermund H, Hodgett J, Ansfield FJ (1961) Effects of combined irradiation and chemotherapy on transplanted tumors in mice. Am J Roentgenol 85:559–567Google Scholar
  78. 78.
    Walsh D (1897) Deep tissue traumatism from roentgen ray exposure. Br Med J ii:272–273CrossRefGoogle Scholar
  79. 79.
    WHO (1979) Handbook for reporting results of cancer treatment. World Health Organization, GenevaGoogle Scholar
  80. 80.
    Williams NS (1993) Radiotherapy and chemotherapy for primary colorectal cancer, surveillance and recurrence. In: Williams NS, Keighley MRB (eds) Surgery of the anus, rectum and colon. Saunders, London, pp 1054–1091Google Scholar
  81. 81.
    Withers HR, Chu AM, Reid BO, Hussey DH (1975) Response of mouse jejunum to multifractioned radiation. Int J Radiat Oncol Biol Phys 1:41–52PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • H. A. Vuilleumier
  • E. D. Reis

There are no affiliations available

Personalised recommendations