Gut and Liver

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Gastrointestinal Hemorrhage after Concurrent Chemoradiotherapy in Locally Advanced Pancreatic Cancer

Kyong Joo Lee*, Hee Man Kim*, Joo Won Jung*, Moon Jae Chung*, Jeong Youp Park*, Seungmin Bang*, Seung Woo Park*, Woo Jung Lee, Jin Sil Seong, and Si Young Song*,,
*Division of Gastroenterology, Department of Internal Medicine, Departments of Surgery, Radiation Oncology, Brain Korea 21 Project for Medical Science, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background/Aims: While chemoradiotherapy (CRT) is considered to be a reasonable treatment for locally advanced pancreatic cancer (LAPC), there is little information about the associated risk of gastrointestinal (GI) hemorrhage. We investigated the clinical features of GI toxicity after CRT in patients with LAPC and examined the effect of GI hemorrhage on survival. Methods: Patients enrolled in this study had received CRT for pathologically proven LAPC. Their medical records were retrospectively reviewed. Results: A total of 156 patients with LAPC (median age, 65 years; range, 39 to 90 years) who received treatment between August 2005 and March 2009 were included in this study. The most common GI toxicities were ulcer formation (25.6%) and hemorrhage (25.6%), and the most common grade 3 to grade 5 GI toxicity was hemorrhage (65%). The origins of GI hemorrhage were gastric ulcer (37.5%), duodenal ulcer (37.5%), and radiation gastritis (15.0%). The independent risk factor for GI hemorrhage was tumor location in the pancreatic body. The median overall survival of the patients with a GI hemorrhage was 13.8 months (range, 2.8 to 50.8 months) and was not significantly different from that of patients without GI hemorrhage. Conclusions: GI hemorrhage was common in patients with LAPC after CRT. Although GI hemorrhage was controlled with endoscopic hemostasis, preventive measures should be investigated to reduce needless suffering. (Gut Liver 2013;7:106-111)
Chemoradiotherapy; Gastrointestinal hemorrhage; Toxicities; Pancreatic neoplasms
Gut and Liver 2013 Jan; 7(1): 106-111
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