Late effects of radiation therapy on the gastrointestinal tract

Lawrence R. Coia, Robert J. Myerson, Joel E. Tepper

    Research output: Contribution to journalArticlepeer-review

    350 Scopus citations

    Abstract

    Late gastrointestinal complications of radiation therapy have been recognized but not extensively studied. In this paper, the late effects of radiation on three gastrointestinal sites, the esophagus, the stomach, and the bowel, are described. Esophageal dysmotility and benign stricture following esophageal irradiation are predominantly a result of damage to the esophageal wall, although mucosal ulcerations also may persist following high-dose radiation. The major late morbidity following gastric irradiation is gastric ulceration caused by mucosal destruction. Late radiation injury to the bowel, which may result in bleeding, frequency, fistula formation, and, particularly in small bowel, obstruction, is caused by damage to the entire thickness of the bowel wall, and predisposing factors have been identified. For each site a description of the pathogenesis, clinical findings, and present management is offered. Simple and reproducible endpoint scales for late toxicity measurement were developed and are presented for each of the three gastrointestinal organs. Factors important in analyzing late complications and future considerations in evaluation and management of radiation-related gastrointestinal injury are discussed.

    Original languageEnglish
    Pages (from-to)1213-1236
    Number of pages24
    JournalInternational journal of radiation oncology, biology, physics
    Volume31
    Issue number5
    DOIs
    StatePublished - Mar 30 1995

    Keywords

    • Bowel complications of radiation
    • Esophageal stricture
    • Gastric ulceration
    • Gastrointestinal radiation injury

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