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Titolo:
Oral administration of recombinant human granulocyte macrophage colony-stimulating factor in the management of radiotherapy-induced esophagitis
Autore:
Koukourakis, MI; Flordellis, CS; Giatromanolaki, A; Koukouraki, S; Kapsoritakis, A; Potamianos, S; Retalis, G; Sivridis, E; Salsaa, B; Harris, AL; Maragoudakis, MI;
Indirizzi:
Tumour & Angiogenesis Res Grp, Iraklion 71306, Crete, Greece Tumour & Angiogenesis Res Grp Iraklion Crete Greece 71306 , Crete, Greece Churchill Hosp, Imperial Canc Res Fund, Med Oncol Unit, Oxford OX3 7LJ, England Churchill Hosp Oxford England OX3 7LJ ncol Unit, Oxford OX3 7LJ, England Univ Patras, Sch Med, Dept Pharmacol, GR-26110 Patras, Greece Univ PatrasPatras Greece GR-26110 pt Pharmacol, GR-26110 Patras, Greece Univ Hosp Heraklion, Dept Radiotherapy & Oncol, Heraklion 71110, Crete, Greece Univ Hosp Heraklion Heraklion Crete Greece 71110 ion 71110, Crete, Greece Univ Hosp Heraklion, Dept Nucl Med, Heraklion 71110, Crete, Greece Univ Hosp Heraklion Heraklion Crete Greece 71110 ion 71110, Crete, Greece Univ Hosp Heraklion, Dept Gastroenterol, Heraklion 71110, Crete, Greece Univ Hosp Heraklion Heraklion Crete Greece 71110 ion 71110, Crete, Greece
Titolo Testata:
CLINICAL CANCER RESEARCH
fascicolo: 12, volume: 5, anno: 1999,
pagine: 3970 - 3976
SICI:
1078-0432(199912)5:12<3970:OAORHG>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
CELL LUNG-CANCER; BONE-MARROW TRANSPLANTATION; INDUCED MUCOSITIS; DOUBLE-BLIND; ENDOTHELIAL-CELLS; CHEMOTHERAPY; TRIAL; RADIOSENSITIVITY; ACTIVATION; EXPRESSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Koukourakis, MI Tumour & Angiogenesis Res Grp, 18 Dimokratias Ave, Iraklion 71306, Crete, Greece Tumour & Angiogenesis Res Grp 18 Dimokratias Ave Iraklion Crete Greece 71306
Citazione:
M.I. Koukourakis et al., "Oral administration of recombinant human granulocyte macrophage colony-stimulating factor in the management of radiotherapy-induced esophagitis", CLIN CANC R, 5(12), 1999, pp. 3970-3976

Abstract

Radiation-induced esophagitis often results in treatment interruption, which may severely affect the probability of control of the local disease in patients undergoing chest radiotherapy (RT), No effective regimen that wouldreduce the incidence and severity of this complication has been identifiedup to now. Although acceleration of oral mucosal healing using topical recombinant human granulocyte macrophage colony-stimulating factor (rhGM-CSF) has been reported, the mechanism of such an interaction remains obscure. Effective topical application of rhGM-CSF for the treatment of radiation-induced esophagitis has never been reported in the past. In pharmacological studies, we observed that glycerol exerts a remarkable stabilizing effect on rhGM-CSF immunoreactivity, After studying the kinetics of esophageal emptying with nuclear imaging, me proposed a rhGM-CSF regimen that could be applied for topical treatment of esophagitis during RT, The regimen was applied for 5 consecutive days in a cohort of 36 patients undergoing chest RT, immediately after the documentation of grade 3 esophagitis, RT was not interrupted. Mucosal biopsies were performed endoscopically and examined immunohistochemically, Regression of dysphagia to grade 0/1 was observed in 19 of 36 (52%) patients, whereas grade 2 dysphagia persisted in 12 of 36 (33%) patients. Progression of dysphagia was seen in 5 of 36 (14%) patients, Recurrenceof severe esophagitis within 5-8 days after rhGM-CSF therapy was observed in 7 of 31 (22%) patients with initial response to rhGM-CSF, Pour of these patients presented significant improvement of symptomatology after additional rhGM-CSF medication. In immunohistochemical studies, active intraepithelial neovascularization and thymidine phosphorylase and vascular endothelialgrowth factor overexpression were observed in the damaged epithelium, which was not accompanied by macrophage or neutrophil infiltration, We concludethat rhGM-CSF topical therapy (p.o. administration) exerts a significant therapeutic effect against RT-induced esophagitis, The rhGM-CSF mucosa healing effect is probably due to its direct angiogenic activity and/or to the potentiation of the activity of other angiogenic factors released by the damaged epithelium.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 15/07/20 alle ore 21:23:37