LETTER

Treatment of local ischaemia: another promising approach for gastrointestinal complications of pelvic radiotherapy

T Konishi, T Watanabe and H Nagawa

Department of Surgical Oncology, University of Tokyo, Tokyo, Japan

Correspondence to:
Correspondence to:
Dr T Konishi
Department of Surgical Oncology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; tsuyoshikonishi@pop07.odn.ne.jp

Keywords: complications; radiation; ischaemia; fibrosis

The first 150 words of the full text of this article appear below.

We read with great interest the review of gastrointestinal complications after pelvic radiotherapy by Andreyev (Gut 2005;54:1051–4). Andreyev emphasised the importance of fibrosis as the underlying cause for most gastrointestinal symptoms after radiotherapy and concluded that reversal or prevention of fibrosis could be highly profitable in the treatment of this complication, referring several antifibrotic agents such as liposomal Cu/Zn superoxide dismutase.¹ However, there is another important target for the treatment of this complication—that is, local ischaemia.

Ischaemia and fibrosis together play an important role in the development of chronic gastrointestinal complications after radiotherapy. Histological examinations have revealed that radiation induces characteristic vascular damage in the bowel, including marked fibrin thrombi and destruction of arterioles with subintimal thickening.^2,3 This vascular damage deteriorates the local blood supply, and persistent local ischaemia leads to diffuse fibrosis in the lamina propria and submucosa of the bowel wall. Then, fibrosis in . . . [Full text of this article]

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