Document Detail


Management of painful chronic pancreatitis with single-dose radiotherapy.
MedLine Citation:
PMID:  19190609     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Some patients with chronic pancreatitis present recurrent flare-ups of pancreatitis and/or unrelenting pain. Current management is mostly limited to analgesics and surgery. We reasoned that anti-inflammatory radiotherapy, which has proven useful to alleviate other painful inflammatory painful disorders, might prove valuable for severely symptomatic patients with chronic pancreatitis. METHODS: We prospectively studied the efficacy of single-dose anti-inflammatory radiotherapy in 15 consecutive patients with chronic pancreatitis who fulfilled the following criteria: either two flare-ups of pancreatitis in the previous 6 months and/or continuous pain for more than 3 months. Treatment consisted of a single radiation dose of 8 Gy to the pancreas. Exocrine function (fecal elastase), endocrine function (c peptide), quality of life (EuroQol questionnaire), and clinical outcome were assessed before and after radiation. Response was defined as no further pain or flare-ups of pancreatitis. RESULTS: During follow-up (median: 39 months; range: 4-72 months), 12 patients had no further pain or flare-ups. One patient required a second radiation dose 1 year after the initial treatment, but he has remained well ever since (50 months). Two other patients did not respond to radiotherapy. After radiotherapy either exocrine or endocrine pancreatic function, or both, deteriorated in three patients. Patients who responded to treatment (13/15) gained 4-20 kg in body weight during follow-up (median 4 kg) and EuroQol improved significantly from 0.58 to 0.86 (P<0.001). CONCLUSIONS: Radiotherapy for severe symptomatic chronic pancreatitis appears to be a useful and effective therapeutic choice that could potentially substitute for or delay surgery.
Authors:
Luisa Guarner; Begoña Navalpotro; Xavier Molero; Jordi Giralt; J-R Malagelada
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-01-27
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  104     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-04     Completed Date:  2009-03-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  349-55     Citation Subset:  IM    
Affiliation:
Digestive Disease Research Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain. lguarner@vhebron.net
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / etiology,  radiotherapy*
Adult
Aged
Aged, 80 and over
Follow-Up Studies
Humans
Middle Aged
Pancreatitis, Chronic / complications*,  pathology,  radiotherapy*
Pilot Projects
Prospective Studies
Quality of Life
Radiotherapy Dosage
Radiotherapy, Computer-Assisted / methods*
Recovery of Function
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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