Ahmed Monjur, Ahmed Razin
Division of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
California Cancer Associates for Research and Excellence, Fresno, CA, USA.
Gastroenterology Res. 2022 Dec;15(6):285-296. doi: 10.14740/gr1567. Epub 2022 Dec 18.
The benefit of radiation is immense in the field of gastroenterology. Radiation is used daily in different gastrointestinal imaging and diagnostic and therapeutic interventional procedures. Radiotherapy is one of the primary modalities of treatment of gastrointestinal malignancies. There are various modalities of radiotherapy. Radiotherapy can injure malignant cells by directly damaging DNA, RNA, proteins, and lipids and indirectly by forming free radicals. External beam radiation, internal beam radiation and radio-isotope therapy are the major ways of delivering radiation to the malignant tissue. Radiation can also cause inflammation, fibrosis, organ dysfunction, and malignancy. Patients with repeated exposure to radiation for diagnostic imaging and therapeutic procedures are at slightly increased risk of malignancy. Gastrointestinal endoscopists performing fluoroscopy-guided procedures are also at increased risk of malignancy and cataract formation. The radiological protection society recommends certain preventive and protective measures to avoid side effects of radiation. Gastrointestinal complications related to radiation therapy for oncologic processes, and exposure risks for patients and health care providers involved in diagnostic or therapeutic imaging will be discussed in this review.
放射治疗在胃肠病学领域的益处是巨大的。放射治疗每天都用于不同的胃肠道成像以及诊断和治疗性介入程序。放射疗法是胃肠道恶性肿瘤的主要治疗方式之一。放射疗法有多种形式。放射疗法可通过直接损伤DNA、RNA、蛋白质和脂质以及通过形成自由基间接损伤恶性细胞。外照射、内照射和放射性同位素疗法是向恶性组织输送辐射的主要方式。辐射还可导致炎症、纤维化、器官功能障碍和恶性肿瘤。因诊断成像和治疗程序而反复接触辐射的患者患恶性肿瘤的风险略有增加。进行荧光透视引导程序的胃肠内镜医师患恶性肿瘤和白内障的风险也会增加。放射防护协会推荐了某些预防和保护措施以避免辐射的副作用。本综述将讨论与肿瘤治疗过程中的放射治疗相关的胃肠道并发症，以及参与诊断或治疗成像的患者和医护人员的暴露风险。
