Takatori Kento, Terashima Kazuki, Yoshida Rihito, Horai Aya, Satake Shinya, Ose Takayuki, Kitajima Naoto, Kinoshita Yoshikazu, Demizu Yusuke, Fuwa Nobukazu
Department of Internal Medicine, Kasai City Hospital, 1-13 Yokoo, Houjou, Kasai, Hyogo, 675-2393, Japan,
J Gastroenterol. 2014 Jun;49(6):1074-80. doi: 10.1007/s00535-013-0857-3. Epub 2013 Jul 12.
Little is known about acute upper gastrointestinal (GI) complications associated with gemcitabine-concurrent proton radiotherapy (GPT) for inoperable pancreatic cancer. We investigated acute GI complications following GPT in patients with inoperable pancreatic cancer using small-bowel endoscopy.
This prospective single center observational study was conducted at the Hyogo Ion Beam Medical Center from January 2010 to January 2012. Ninety-one patients who had clinically and medically inoperable pancreatic cancer treated by GPT were analyzed. Endoscopic examinations were performed before and after GPT to clarify the incidence rates of radiation-induced ulcers, GI hemorrhage, and GI perforation associated with GPT.
Post-treatment endoscopic examinations revealed that 45 (49.4 %) patients had radiation-induced ulcers in the stomach and duodenum. Of those, many ulcerative lesions were found in the lower stomach (51 %) and horizontal part of the duodenum (39 %), regardless of the primary tumor site in the pancreas. Neither GI hemorrhage, nor perforation, was found in post-treatment endoscopy examinations.
Approximately half of the patients treated with GPT for inoperable pancreatic cancer exhibited radiation-induced ulcers in the stomach and duodenum.
关于吉西他滨同步质子放疗（GPT）治疗不可切除胰腺癌相关的急性上消化道（GI）并发症知之甚少。我们使用小肠内镜研究了GPT治疗不可切除胰腺癌患者后的急性GI并发症。
本前瞻性单中心观察性研究于2010年1月至2012年1月在兵库离子束医学中心进行。分析了91例接受GPT治疗的临床和医学上不可切除胰腺癌患者。在GPT治疗前后进行内镜检查，以明确与GPT相关的放射性溃疡、GI出血和GI穿孔的发生率。
治疗后内镜检查显示，45例（49.4%）患者胃和十二指肠出现放射性溃疡。其中，无论胰腺原发肿瘤部位如何，在下胃（51%）和十二指肠水平部（39%）发现了许多溃疡性病变。治疗后内镜检查未发现GI出血和穿孔。
约一半接受GPT治疗的不可切除胰腺癌患者胃和十二指肠出现放射性溃疡。
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