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  • 1 Uzsoki Utcai Kórház Sebészet-Érsebészeti Osztály Budapest Uzsoki út 29. 1145
  • 2 Uzsoki Utcai Kórház Onkoradiológiai Osztály Budapest
  • 3 Tumorgenetika Biobank Klaszter Budapest
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A sugárkezelés által okozott bélgyulladás a hasi és kismedencei irradiáció egyik legrettegettebb szövődménye. Az incidencia 0,5–5% között változik. Nemegyszer előfordul, hogy a progrediáló kórkép a beteg halálát okozza. A szerzők 13 éves periódus alatt 24 betegről számolnak be, akiknél irradiációs enteritis szövődménye miatt műtétet végeztek. A különféle műtéti megoldások ellenére az esetek 25%-ában reoperáció volt szükséges, végül négy beteg meghalt. Az esetek elemzése kapcsán a kórkép kialakulását előidéző hajlamosító tényezők és a különböző terápiás lehetőségek kerülnek bemutatásra. A sugárkezelés által okozott krónikus bélgyulladás terápiás lehetőségei korlátozottak, azonban célzott kezeléssel jelentősen jobb eredmények érhetők el. A megfelelő terápiás terv felállításához az onkológus, a gasztroenterológus és a sebész együttműködésére van szükség. Orv. Hetil., 2011, 152, 1120–1124.

  • Walsh, D.: Deep tissue traumatism from roentgen ray exposure. Br. Med. J., 1897, 2, 272–273.

    Walsh D. , 'Deep tissue traumatism from roentgen ray exposure ' (1897 ) 2 Br. Med. J. : 272 -273.

    • Search Google Scholar
  • Wobbes, T., Verschueren, R. C. J., Lubbers, E. J. C.: Surgical aspects of radiation enteritis of the small bowel. Dis. Colon. Rectum, 1984, 27, 89–92.

    Lubbers E. J. C. , 'Surgical aspects of radiation enteritis of the small bowel ' (1984 ) 27 Dis. Colon. Rectum : 89 -92.

    • Search Google Scholar
  • Galland, R. B., Spencer, J.: Natural history and surgical management of radiation enteritis. Br. J. Surg., 1987, 74, 742–747.

    Spencer J. , 'Natural history and surgical management of radiation enteritis ' (1987 ) 74 Br. J. Surg. : 742 -747.

    • Search Google Scholar
  • Sinkó D., Baranyai Zs., Nemeskéri Cs.: Sugárkezelés mellett fellépő bélgyulladások tünettana, diagnosztikája, terápiás lehetőségei. Orv. Hetil., 2010, 151, 1450–1454.

    Nemeskéri Cs. , 'Sugárkezelés mellett fellépő bélgyulladások tünettana, diagnosztikája, terápiás lehetőségei ' (2010 ) 151 Orv. Hetil. : 1450 -1454.

    • Search Google Scholar
  • Saclarides, T. J.: Radiation injuries of the gastrointestinal tract. Surg. Clin. North Am., 1997, 77, 261–268.

    Saclarides T. J. , 'Radiation injuries of the gastrointestinal tract ' (1997 ) 77 Surg. Clin. North Am. : 261 -268.

    • Search Google Scholar
  • Ooi, B. S., Tjandra, J. J., Green, M. D.: Morbidities of adjuvant chemotherapy and radiotherapy for resectable rectal cancer: an overview. Dis. Colon. Rectum, 1999, 42, 403–418.

    Green M. D. , 'Morbidities of adjuvant chemotherapy and radiotherapy for resectable rectal cancer: an overview ' (1999 ) 42 Dis. Colon. Rectum : 403 -418.

    • Search Google Scholar
  • Daly, N. J., Izar, F., Bachaud, J. M. és mtsa: The incidence of severe chronic ileitis after abdominal and/or pelvic external irradiation with high energy photon beams. Radiother. Oncol., 1989, 14, 287–295.

    Bachaud J. M. , 'The incidence of severe chronic ileitis after abdominal and/or pelvic external irradiation with high energy photon beams ' (1989 ) 14 Radiother. Oncol. : 287 -295.

    • Search Google Scholar
  • Miller, A. R., Martenson, J. A., Nelson, H. és mtsai: The incidence and clinical consequence soft reatment-related bowel injury. Int. J. Radiat. Oncol. Biol. Phys., 1999, 43, 817–825.

    Nelson H. , 'The incidence and clinical consequence soft reatment-related bowel injury ' (1999 ) 43 Int. J. Radiat. Oncol. Biol. Phys. : 817 -825.

    • Search Google Scholar
  • Yeoh, E., Razali, M., O’Brien, P. C.: Radiation therapy for early stage seminoma of the testis. Analysis of survival and gastrointestinal toxicity in patients treated with modern megavoltage techniques over 10 years. Australas. Radiol., 1993, 37, 367–369.

    O’Brien P. C. , 'Radiation therapy for early stage seminoma of the testis. Analysis of survival and gastrointestinal toxicity in patients treated with modern megavoltage techniques over 10 years ' (1993 ) 37 Australas. Radiol. : 367 -369.

    • Search Google Scholar
  • Karlsdóttir, A., Johannessen, D. C., Muren, L. P. és mtsai: Acute morbidity related to treatment volume during 3D-conformal radiation therapy for prostate cancer. Radiother. Oncol., 2004, 71, 43–53.

    Muren L. P. , 'Acute morbidity related to treatment volume during 3D-conformal radiation therapy for prostate cancer ' (2004 ) 71 Radiother. Oncol. : 43 -53.

    • Search Google Scholar
  • Huh, S. J., Park, W., Han, Y.: Interfractional variation in position of the uterus during radical radiotherapy for cervical cancer. Radiother. Oncol., 2004, 71, 73–79.

    Han Y. , 'Interfractional variation in position of the uterus during radical radiotherapy for cervical cancer ' (2004 ) 71 Radiother. Oncol. : 73 -79.

    • Search Google Scholar
  • Huh, S. J., Han, Y., Park, W. és mtsa: Interfractional dose variation due to seromas in radiotherapy of breast cancer. Med. Dosim., 2005, 30, 8–11.

    Park W. , 'Interfractional dose variation due to seromas in radiotherapy of breast cancer ' (2005 ) 30 Med. Dosim. : 8 -11.

    • Search Google Scholar
  • Kountouras, J., Zavos, C.: Recent advances in the management of radiation colitis. World J. Gastroenterol., 2008, 14, 7289–7301.

    Zavos C. , 'Recent advances in the management of radiation colitis ' (2008 ) 14 World J. Gastroenterol. : 7289 -7301.

    • Search Google Scholar
  • Theis, V. S., Sripadam, R., Ramani, V. és mtsa: Chronic radiation enteritis. Clin. Oncol., 2010, 22, 70–83.

    Ramani V. , 'Chronic radiation enteritis ' (2010 ) 22 Clin. Oncol. : 70 -83.

  • Girvent, M., Carlson, G. L., Anderson, I. és mtsai: Intestinal failure after surgery for complicated radiation enteritis. Ann. R. Coll. Surg. Engl., 2000, 82, 198–201.

    Anderson I. , 'Intestinal failure after surgery for complicated radiation enteritis ' (2000 ) 82 Ann. R. Coll. Surg. Engl. : 198 -201.

    • Search Google Scholar
  • Bismar, M. M., Sinicrope, F. A.: Radiation enteritis. Curr. Gastroenterol. Rep., 2002, 4, 361–365.

    Sinicrope F. A. , 'Radiation enteritis ' (2002 ) 4 Curr. Gastroenterol. Rep. : 361 -365.

  • McGovern, D.: Radiation and other physiochemical injury. In: Clinical gastroenterology and hepatology. Eds: Weinstein, W. M., Hawkey, C. J., Bosch, J. Elsevier Mosby, 2005.

    McGovern D. , '', in Clinical gastroenterology and hepatology , (2005 ) -.

  • MacNaughton, W. K.: Review article: new insights into the pathogenesis of radiation-induced intestinal dysfunction. Aliment. Pharmacol. Ther., 2000, 14, 523–528.

    MacNaughton W. K. , 'Review article: new insights into the pathogenesis of radiation-induced intestinal dysfunction ' (2000 ) 14 Aliment. Pharmacol. Ther. : 523 -528.

    • Search Google Scholar
  • Nguyen, N. P., Antoine, J. E., Dutta, S. és mtsai: Current concepts in radiation enteritis and implications for future clinical trials. Cancer, 2002, 95, 1151–1163.

    Dutta S. , 'Current concepts in radiation enteritis and implications for future clinical trials ' (2002 ) 95 Cancer : 1151 -1163.

    • Search Google Scholar
  • Strup-Perrot, C., Mathe, D., Linard, C. és mtsai: Global gene expression profiles reveal an increase in mRNA levels of collagens, MMPs, and TIMPs in late radiation enteritis. Am. J. Physiol. Gastrointest. Liver Physiol., 2004, 287, G875–G885.

    Linard C. , 'Global gene expression profiles reveal an increase in mRNA levels of collagens, MMPs, and TIMPs in late radiation enteritis ' (2004 ) 287 Am. J. Physiol. Gastrointest. Liver Physiol. : G875 -G885.

    • Search Google Scholar
  • Rodier, J. F.: Radiation enteropathy – incidence, aetiology, risk factors, pathology and symptoms. Tumori, 1995, 81 (Suppl. 3), 122–125.

    Rodier J. F. , 'Radiation enteropathy – incidence, aetiology, risk factors, pathology and symptoms ' (1995 ) 81 Tumori : 122 -125.

    • Search Google Scholar
  • Andreyev, H. J., Vlavianos, P., Blake, P. és mtsai: Gastrointestinal symptoms after pelvic radiotherapy: role for the gastroenterologist? Int. J. Radiat. Oncol. Biol. Phys., 2005, 62, 1464–1471.

    Blake P. , 'Gastrointestinal symptoms after pelvic radiotherapy: role for the gastroenterologist? ' (2005 ) 62 Int. J. Radiat. Oncol. Biol. Phys. : 1464 -1471.

    • Search Google Scholar
  • Danielsson, A., Nyhlin, H., Persson, H. és mtsai: Chronic diarrhoea after radiotherapy for gynaecological cancer: occurrence and aetiology. Gut, 1991, 32, 1180–1187.

    Persson H. , 'Chronic diarrhoea after radiotherapy for gynaecological cancer: occurrence and aetiology ' (1991 ) 32 Gut : 1180 -1187.

    • Search Google Scholar
  • Arlow, F. L., Dekovich, A. A., Priest, R. J. és mtsai: Bile acids in radiation induced diarrhea. South Med. J., 1987, 80, 1259–1261.

    Priest R. J. , 'Bile acids in radiation induced diarrhea ' (1987 ) 80 South Med. J. : 1259 -1261.

    • Search Google Scholar
  • Kamal-Bahl, S. J., Burke, T., Watson, D. és mtsai: Discontinuation of lipid modifying drugs among commercially insured United States patients in recent clinical practice. Am. J. Cardiol., 2007, 99, 530–534.

    Watson D. , 'Discontinuation of lipid modifying drugs among commercially insured United States patients in recent clinical practice ' (2007 ) 99 Am. J. Cardiol. : 530 -534.

    • Search Google Scholar
  • Bujko, K., Nowacki, M. P., Nasierowska-Guttmejer, A. és mtsai: Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br. J. Surg., 2006, 93, 1215–1223.

    Nasierowska-Guttmejer A. , 'Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer ' (2006 ) 93 Br. J. Surg. : 1215 -1223.

    • Search Google Scholar
  • Swedish Rectal Cancer Trial 1997. Collaborators: Cedermark, B., Dahlberg, M., Glimelius, B. és mtsai: Improved survival with preoperative radiotherapy in resectable rectal cancer. N. Engl. J. Med., 1997, 336, 980–987.

    Glimelius B. , 'Improved survival with preoperative radiotherapy in resectable rectal cancer ' (1997 ) 336 N. Engl. J. Med. : 980 -987.

    • Search Google Scholar
  • Birgisson, H., Pahlman, L., Gunnarsson, U. és mtsai: Adverse effects of preoperative radiation therapy for rectal cancer: long-term follow-up of the Swedish Rectal Cancer Trial. J. Clin. Oncol., 2005, 23, 8697–8705.

    Gunnarsson U. , 'Adverse effects of preoperative radiation therapy for rectal cancer: long-term follow-up of the Swedish Rectal Cancer Trial ' (2005 ) 23 J. Clin. Oncol. : 8697 -8705.

    • Search Google Scholar
  • Bosset, J. F., Collette, L., Calais, G. és mtsai: Chemotherapy with preoperative radiotherapy in rectal cancer. N. Engl. J. Med., 2006, 355, 1114–1123.

    Calais G. , 'Chemotherapy with preoperative radiotherapy in rectal cancer ' (2006 ) 355 N. Engl. J. Med. : 1114 -1123.

    • Search Google Scholar
  • Kirwan, J. M., Symonds, P., Green, J. A. és mtsai: A systematic review of acute and late toxicity of concomitant chemoradiation for cervical cancer. Radiother. Oncol., 2003, 68, 217–226.

    Green J. A. , 'A systematic review of acute and late toxicity of concomitant chemoradiation for cervical cancer ' (2003 ) 68 Radiother. Oncol. : 217 -226.

    • Search Google Scholar
  • Rakovitch, E., Fyles, A. W., Pintilie, M. és mtsai: Role of mitomycin C in the development of late bowel toxicity following chemoradiation for locally advanced carcinoma of the cervix. Int. J. Radiat. Oncol. Biol. Phys., 1997, 38, 979–987.

    Pintilie M. , 'Role of mitomycin C in the development of late bowel toxicity following chemoradiation for locally advanced carcinoma of the cervix ' (1997 ) 38 Int. J. Radiat. Oncol. Biol. Phys. : 979 -987.

    • Search Google Scholar
  • Marshall, G. T., Thirlby, R. C., Bredfeldt, J. E. és mtsa: Treatment of gastrointestinal radiation injury with hyperbaric oxygen. Undersea Hyperb. Med., 2007, 34, 35–42.

    Bredfeldt J. E. , 'Treatment of gastrointestinal radiation injury with hyperbaric oxygen ' (2007 ) 34 Undersea Hyperb. Med. : 35 -42.

    • Search Google Scholar
  • Zinicola, R., Rutter, M. D., Giuliano, F.: Haemorrhagic radiation proctitis: endoscopic severity may be useful to guide therapy. Int. J. Colorectal Dis., 2003, 18, 439–444.

    Giuliano F. , 'Haemorrhagic radiation proctitis: endoscopic severity may be useful to guide therapy ' (2003 ) 18 Int. J. Colorectal Dis. : 439 -444.

    • Search Google Scholar
  • Toyoda, H., Jaramillo, E., Mukai, K. és mtsai: Treatment of radiation induced hemorrhagic duodenitis with argon plasma coagulation. Endoscopy, 2004, 36, 192.

    Mukai K. , 'Treatment of radiation induced hemorrhagic duodenitis with argon plasma coagulation ' (2004 ) 36 Endoscopy : 192 -.

    • Search Google Scholar
  • Kita, H., Yamamoto, H., Yano, T. és mtsai: Double balloon endoscopy in two hundred fifty cases for the diagnosis and treatment of small intestinal disorders. Inflammopharmacology, 2007, 15, 74–77.

    Yano T. , 'Double balloon endoscopy in two hundred fifty cases for the diagnosis and treatment of small intestinal disorders ' (2007 ) 15 Inflammopharmacology : 74 -77.

    • Search Google Scholar
  • Teknős D., Baranyai Zs., Sinkó, D. és mtsa: Irradiációs enteritis sebészeti prevenciója: esetismertetés és irodalom áttekintése. Magy. Seb., 2011, 64, 85–88.

    Sinkó D. , 'Irradiációs enteritis sebészeti prevenciója: esetismertetés és irodalom áttekintése ' (2011 ) 64 Magy. Seb. : 85 -88.

    • Search Google Scholar
  • Regimbeau, J. M., Panis, Y., Gouzi, J. L. és mtsai: Operative and long term results after surgery for chronic radiation enteritis. Am. J. Surg., 2001, 182, 237–242.

    Gouzi J. L. , 'Operative and long term results after surgery for chronic radiation enteritis ' (2001 ) 182 Am. J. Surg. : 237 -242.

    • Search Google Scholar
  • Galland, R. B., Spencer, J.: Surgical management of radiation enteritis. Surgery, 1986, 99, 133–139.

    Spencer J. , 'Surgical management of radiation enteritis ' (1986 ) 99 Surgery : 133 -139.

  • Kuroki, F., Iida, M., Matsui, T. és mtsai: Intraoperative endoscopy for small intestinal damage in radiation enteritis. Gastrointest. Endosc., 1992, 38, 196–197.

    Matsui T. , 'Intraoperative endoscopy for small intestinal damage in radiation enteritis ' (1992 ) 38 Gastrointest. Endosc. : 196 -197.

    • Search Google Scholar
  • Regimbeau, J. M., Panis, Y., Gouzi, J. L. és mtsai: Operative and long term results after surgery for chronic radiation enteritis. Am. J. Surg., 2001, 182, 237–242.

    Gouzi J. L. , 'Operative and long term results after surgery for chronic radiation enteritis ' (2001 ) 182 Am. J. Surg. : 237 -242.

    • Search Google Scholar