title: Upper gastrointestinal complications associated with gemcitabine-concurrent proton radiotherapy for inoperable pancreatic cancer.
abstract: BACKGROUND
  Little is known about acute upper gastrointestinal (GI) complications associated with gemcitabine-concurrent proton radiotherapy (GPT) for inoperable pancreatic cancer. We investigated acute GI complications following GPT in patients with inoperable pancreatic cancer using small-bowel endoscopy.
  
  
  METHODS
  This prospective single center observational study was conducted at the Hyogo Ion Beam Medical Center from January 2010 to January 2012. Ninety-one patients who had clinically and medically inoperable pancreatic cancer treated by GPT were analyzed. Endoscopic examinations were performed before and after GPT to clarify the incidence rates of radiation-induced ulcers, GI hemorrhage, and GI perforation associated with GPT.
  
  
  RESULTS
  Post-treatment endoscopic examinations revealed that 45 (49.4 %) patients had radiation-induced ulcers in the stomach and duodenum. Of those, many ulcerative lesions were found in the lower stomach (51 %) and horizontal part of the duodenum (39 %), regardless of the primary tumor site in the pancreas. Neither GI hemorrhage, nor perforation, was found in post-treatment endoscopy examinations.
  
  
  CONCLUSIONS
  Approximately half of the patients treated with GPT for inoperable pancreatic cancer exhibited radiation-induced ulcers in the stomach and duodenum.
authors.affiliation: Department of Internal Medicine, Kasai City Hospital, 1-13 Yokoo, Houjou, Kasai, Hyogo, 675-2393, Japan, kent8t8@gmail.com.
authors.forename: Kento
authors.initials: K
authors.lastname: Takatori
authors.forename: Kazuki
authors.initials: K
authors.lastname: Terashima
authors.forename: Rihito
authors.initials: R
authors.lastname: Yoshida
authors.forename: Aya
authors.initials: A
authors.lastname: Horai
authors.forename: Shinya
authors.initials: S
authors.lastname: Satake
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ose
authors.forename: Naoto
authors.initials: N
authors.lastname: Kitajima
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Demizu
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Fuwa
mesh_terms: D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000628:therapy*; D011446:Prospective Studies; D061766:Proton Therapy / Q000009:adverse effects*; D011832:Radiation Injuries / Q000453:epidemiology*; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine