Radiothérapie : Quelles orientations thérapeutiques contre les séquelles digestives ?

Abstract

Radiotherapy; what therapeutic orientations against the digestive aftereffects '? Despite constant progress in radiotherapy techniques such as tumour imaging and cartography, techniques of radiation delivery or fractionation schedules, damage to normal gastro-intestinal tissues is inevitably associated with radiation therapy of pelvic tumours. Acute radiation enteritis concerns 80 % of patients. It is related to stem cell loss, default in epithelial regenerating capacity and infiamrnationinduced mucosai dystrophy and ulceration. Chronic injury may develop in 5 to 10 % of patients and is characterized by intestinal wail fibrosis resulting from an exaggerated scaring process, chronic inflammation and tissue necrosis. Researches in mechanistic processes of norm a! tissue damage paved the way for new therapeutic approaches to emerge. These new targets include mucosai regeneration, reduction of vascular activation, inflammation and thrombosis, and fight against mesenchyma! cells sustained activation. Effective strategies are multiple on preclinical models, but numerous efforts have to be made to achieve the compiicated goal of protection of normal tissues from the side effects of radiation therapy.