Flobert C, Cellier C, Landi B, Berger A, Durdux C, Palazzo L, Carnot F, Cugnenc P H, Barbier J P
Service d'Hépato-Gastroentérologie, Hôpital Laennec, Paris.
Gastroenterol Clin Biol. 1998 Feb;22(2):232-4.
Severe gastric complications due to radiotherapy are uncommon, in particular hemorrhagic gastritis. A high total dose and, above all, high daily fraction appear to be the main risk factors in gastric injuries. A case of hemorrhagic gastritis induced by radiotherapy requesting a total gastrectomy is reported. The patient was treated for a primary gastric non-Hodgkin's lymphoma. Hemorrhagic gastritis occurred despite a low total dose (40 Gy) and 2 Gy daily fractions. Upper gastrointestinal endoscopy and repeated biopsies are usually insufficient to exclude a tumor recurrence. Endoscopic ultrasonography may argue for a recurrence or for radiation lesions. As the conservative treatment is usually ineffective, these gastrointestinal radiation injuries ought to be treated surgically. Besides it allows to ascertain the benign nature of radiation lesions.
放疗引起的严重胃部并发症并不常见,尤其是出血性胃炎。高总剂量,尤其是高每日分次剂量似乎是胃部损伤的主要危险因素。本文报告了一例因放疗诱发出血性胃炎而需行全胃切除术的病例。该患者因原发性胃非霍奇金淋巴瘤接受治疗。尽管总剂量较低(40 Gy)且每日分次剂量为2 Gy,但仍发生了出血性胃炎。上消化道内镜检查和反复活检通常不足以排除肿瘤复发。内镜超声检查可能提示复发或放射性损伤。由于保守治疗通常无效,这些胃肠道放射性损伤应采用手术治疗。此外,手术还可以确定放射性损伤的良性性质。