| 特集名 | 血流障害と消化管疾患 | |
|---|---|---|
| 題名 | その他 (1) 放射線性腸炎 | |
| 発刊年月 | 2019年 01月 | |
| 著者 | 池之山 洋平 | がん研有明病院消化器内科 |
| 著者 | 千野 晶子 | がん研有明病院消化器内科 |
| 著者 | 五十嵐 正広 | がん研有明病院消化器内科 |
| 著者 | 井出 大資 | がん研有明病院消化器内科 |
| 著者 | 斎藤 彰一 | がん研有明病院消化器内科 |
| 【 要旨 】 | 放射線性腸炎は，放射線治療の照射範囲に隣接する腸管に生じる有害事象である．原発巣に応じてさまざまな放射線照射方法があり，頻度の差はあるものの，いずれの照射方法でも放射線性腸炎は起こりうる．病態は，照射中から数週間以内に出現する早期障害と，数カ月以降に発症する晩期障害に分けられるため，発症時期や重症度を考慮した対処が必要である．頻度の高い直腸出血に対しては，アルゴンプラズマ凝固法（APC）が有用であり，潰瘍を伴う場合には高圧酸素療法の併用が効果的である．重症例では狭窄や瘻孔による通過障害が出現する例も少なからず存在し，手術が必要な場合もあるが，術後合併症の可能性を考慮した対応が必要となる． | |
| Theme | Gastrointestinal Disease Due to Blood Flow Damage | |
|---|---|---|
| Title | Radiation Colitis | |
| Author | Yohei Ikenoyama | Division of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research |
| Author | Akiko Chino | Division of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research |
| Author | Masahiro Igarashi | Division of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research |
| Author | Daisuke Ide | Division of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research |
| Author | Shoichi Saito | Division of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research |
| [ Summary ] | Radiotherapy is often the first-line treatment for pelvic malignancies including prostate and uterine cancer. Radiation-induced colitis is an adverse effect observed in the intestinal tract adjoining the areas receiving irradiation. Various irradiation methods are used depending upon the target disease, and all methods are known to induce radiation colitis, although there is a difference in frequency. Based on its pathogenesis, radiation enterocolitis is categorized into acute injury that occurs within several weeks of irradiation and late injury that develops several months after radiotherapy. The disease state and severity need to be considered for optimal treatment. Radiation causes acute and chronic adverse effects on the small and large intestines including hemorrhagic sigmoid proctitis, ulcer, stenosis, and fistula formation. The presence of blood in stools is the most common symptom, and argon plasma coagulation is an easy, safe, and effective treatment option. Hyperbaric oxygen therapy is a promising approach for radiation-induced ulcers. Surgery may effectively treat radiation-induced fistulas and stenosis. However, surgical indications should be carefully assessed because surgery leads to a high morbidity rate. |
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