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• W2177415087 abstract "Histology: Each acinus is made up of an irregular cluster of pyramidal secretory cells with apices projecting toward the lumen of a small central duct.Endocrine secretions enter the blood by way of a fine reticular network of fenestrated capillary beds surrounding the islets of Langerhans, which consist of groups of endocrine cells of various sizes.Symptoms: Pancreatic exocrine dysfunction and malabsorption are the most commonly reported complications following pancreatic radiation.Patients may more rarely develop an abnormal glucose tolerance test. Patients may or may not also demonstrate accompanying abnormal random or fasting plasma glucose levels.Radiology: Imaging of the pancreas following radiation is often normal but sometimes radiographic changes consistent with chronic pancreatitis can be observed.Multiple Fractions: At 45 Gy, pancreatic exocrine insufficiency with or without malabsorption has been reported. Hypofractionation. The estimate risk of diabetes is 16% in childhood cancer survivors who have received at least 10 Gy to the tail of the pancreas, with a dose response up to 20 to 29 Gy, and a plateau at higher radiation doses. Stereotactic body radiosurgery has recently been utilized to deliver a range of hypofractionated radiation treatments to patients with pancreatic tumors. Up to 25 Gy delivered in a single fraction has been used for treatment, including some patients who received prior chemotherapy and fractionated external beam radiation.No pancreatic complications were reported in these studies though the number of evaluable patients is small.Recommended dose-volume: As radiation-induced damage to pancreatic function is rarely life threatening and is usually well treated with medical management, dose-volume constraints have not been formally evaluated as with other critical normal tissues.Management: Because pancreatic exocrine deficiency can be managed with replacement therapy, pancreatic injury has not routinely been considered a serious complication compared to other normal tissue damage that may occur from abdominal radiation, such as radiation enteritis. Nonetheless, the risks associated with diabetes and the association with pancreatic tail irradiation in childhood cancer survivors may significantly contribute to public health issues. Hence, the pancreas should be identified as a critical organ for radiation planning purposes, especially in children receiving abdominal irradiation. Long-term follow-up of patients receiving abdominal irradiation should include diabetic screening." @default.
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• W2177415087 date "2013-12-12" @default.
• W2177415087 modified "2023-09-23" @default.
• W2177415087 title "Adverse Late Effects of Radiation Treatment in the Pancreas" @default.
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• W2177415087 doi "https://doi.org/10.1007/978-3-540-75863-1_16" @default.
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