Risk of endocrine pancreatic insufficiency in patients receiving adjuvant chemoradiation for resected gastric cancer

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dc.contributor.authorGemici, Cengiz
dc.contributor.authorSargin, Mehmet
dc.contributor.authorUygur-Bayramicli, Oya
dc.contributor.authorMayadagli, Alpaslan
dc.contributor.authorYaprak, Gokhan
dc.contributor.authorDabak, Resat
dc.contributor.authorKocak, Mihriban
dc.date.accessioned2024-07-12T21:53:03Z
dc.date.available2024-07-12T21:53:03Z
dc.date.issued2013en_US
dc.departmentMaltepe Üniversitesien_US
dc.description.abstractBackground: Adjuvant radiotherapy combined with 5-fluorouracil based chemotherapy has become the new standard after curative resection in high risk gastric cancer. Beside many complications due to surgery, the addition of chemotherapy and radiotherapy as adjuvant treatment may lead to both acute and late toxicities. Pancreatic tissue irradiation during this adjuvant treatment because of incidental and unavoidable inclusion of the organ within the radiation field may affect exocrine and endocrine functions of the organ. Materials and methods: Fifty-three patients with gastric adenocarcinoma were evaluated for adjuvant chemoradiotherapy after surgery. While 37 out of 53 patients were treated postoperatively due to either serosal or adjacent organ or lymph node involvement, 16 patients without these risk factors were followed up regularly without any additional treatment and they served as the control group. Fasting blood glucose (FBG), hemoglobin A1c (HBA1c), insulin and C-peptide levels were measured in the control and study groups after the surgery and 6 months and 1 year later. Results: At the baseline there was no difference in FBG, HbA1c, C-peptide and insulin levels between the control and the study groups. At the end of the study there was a statistically significant decline in insulin and C-peptide levels in the study group, (7.5 +/- 6.0 vs 4.5 +/- 4.4 IU/L, p: 0.002 and 2.3 +/- 0.9 vs 1.56 +/- 0.9 ng/ml, p: 0.001) respectively. Conclusions: Adjuvant radiotherapy in gastric cancer leads to a decrease in beta cell function and insulin secretion capacity of the pancreas with possible diabetes risk. Radiation-induced pancreatic injury and late effects of radiation on normal pancreatic tissue are unknown, but pancreas is more sensitive to radiation than known. This organ should be studied extensively in order to determine the tolerance doses and it should be contoured during abdominal radiotherapy planning as an organ at risk. (C) 2013 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 107 (2013) 195-199en_US
dc.identifier.doi10.1016/j.radonc.2013.04.013
dc.identifier.endpage199en_US
dc.identifier.issn0167-8140
dc.identifier.issn1879-0887
dc.identifier.issue2en_US
dc.identifier.pmid23647754en_US
dc.identifier.scopus2-s2.0-84879031853en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage195en_US
dc.identifier.urihttps://dx.doi.org/10.1016/j.radonc.2013.04.013
dc.identifier.urihttps://hdl.handle.net/20.500.12415/8452
dc.identifier.volume107en_US
dc.identifier.wosWOS:000321804600013en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherELSEVIER IRELAND LTDen_US
dc.relation.ispartofRADIOTHERAPY AND ONCOLOGYen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmzKY03330
dc.subjectGastric canceren_US
dc.subjectAdjuvant radiotherapyen_US
dc.subjectEndocrine pancreatic insufficiencyen_US
dc.subjectDiabetes mellitusen_US
dc.titleRisk of endocrine pancreatic insufficiency in patients receiving adjuvant chemoradiation for resected gastric canceren_US
dc.typeArticle
dspace.entity.typePublication

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