Akutni stranski učinki obsevanja trebuha in medenice Acute side effects of pelvic and abdominal irradiation

Abstract

Obsevanje v področju trebuha in medenice je povezano s pojavom akutnih stranskih učinkov organov, ki se nahajajo v bližini obsevalnega tarčnega volumna. Prizadeto je predvsem tkivo z visoko proliferativno aktivnostjo celic - sluznice sečnega mehurja in gastrointestinalnega trakta, kostni mozeg in koža. Osnovni mehanizem nastanka je poškodba zarodnih celic, ki poruši ravnotežje med odmiranjem zrelih celic in nastajanjem novih. Temu se pridruži še vnetni odziv. Simptomi se običajno pojavijo 2 do 3 tedne po začetku obsevanja in trajajo še nekaj tednov po zaključku zdravljenja. Izrednega pomena je spodbujanje bolnikov k ustreznim preventivnim ukrepom. Zdravljenje je konzervativno in odvisno od stopnje izraženosti težav.

Abstract (Eng)

Irradiation of the abdominal and pelvic cavities can result in acute side effects that are seen in the organs situated near the radiation target volume. The effect of radiotherapy is most potent against tissues with a high cell turnover – mucosa of the bladder and gastrointestinal tract, bone marrow, and skin. The acute symptoms are based on the radiation-induced damage to stem cells, resulting in an imbalance between ongoing cell loss and new cell production. This process is accompanied by inflammatory changes. Acute side effects usually present within 2-3 weeks after the onset of radiation and resolve in a couple of weeks after the completion of treatment. Encouraging patients to take appropriate preventive measures is of utmost importance. Treatment is conservative and depends on the severity of side effects.