Tochner Z, Barnes M, Mitchell J B, Orr K, Glatstein E, Russo A
Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md.
Digestion. 1990;47(2):81-7. doi: 10.1159/000200480.
The mechanism of radiation induced damage to the mucosal lining of the gastrointestinal tract, as well as mucositis, is not fully characterized. Prostaglandins may partially mediate the inflammatory response to radiation damage. The effect of the prostaglandin synthetase inhibitor indomethacin on radiation induced esophagitis, pneumonitis, and tumor response was evaluated in the C3H mouse. The effects of indomethacin on radiation induced damage to the esophagus was determined by evaluation of weigh lost, survival, and histologic findings at doses of 28-34 Gy. Although there is a clear difference that supports the use of indomethacin for the prevention of esophagitis, the radiation dose response for esophagitis is steep and likewise, the therapeutic index for the indomethacin amelioration of radiation esophagitis is narrow. Since the tumor response to radiation is unchanged and since indomethacin clearly lessens radiation induced esophagitis in the mouse, this study suggests that indomethacin should be studied in humans for lessening radiation mucositis without jeopardizing the therapy of tumors.
辐射对胃肠道黏膜内衬造成损伤以及引发黏膜炎的机制尚未完全明确。前列腺素可能部分介导了对辐射损伤的炎症反应。在C3H小鼠中评估了前列腺素合成酶抑制剂吲哚美辛对辐射诱发的食管炎、肺炎及肿瘤反应的影响。通过在28 - 34 Gy剂量下评估体重减轻、存活率及组织学结果，确定了吲哚美辛对辐射诱发食管损伤的作用。尽管存在明显差异支持使用吲哚美辛预防食管炎，但食管炎的辐射剂量反应很陡峭，同样，吲哚美辛改善辐射性食管炎的治疗指数也很窄。由于肿瘤对辐射的反应未改变，且吲哚美辛在小鼠中明显减轻了辐射诱发的食管炎，本研究表明，应在人体中研究吲哚美辛，以减轻辐射性黏膜炎而不危及肿瘤治疗。
