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

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Jerzy WydmanskiBarbara Maslyk

Abstract

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. 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. 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. 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 ...Continue Reading

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Citations

Jun 15, 2018·Journal of Radiation Research·Sei Hwan YouChang Geol Lee
Jul 18, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Paweł PolanowskiKrzysztof Składowski
Jul 14, 2021·CA: a Cancer Journal for Clinicians·Kyle Wang, Joel E Tepper
Aug 16, 2021·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·G Camprodon, F Huguet

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