Enteritis actínica: Fisiopatología, tratamiento y prevención

Gloria María Agudelo Ochoa

Resumen


La radioterapia pélvica es ampliamente utilizada como tratamiento del cáncer ginecológico. El riesgo de complicaciones agudas o crónicas representa un factor limitante en su aplicación, dados los efectos de la radioterapia sobre el intestino sano incluido en el campo irradiado. Entre los factores que se han postulado para explicar el daño en la mucosa, secundario a la radiación, se mencionan reacciones oxidativas, fenómenos inmunológicos y fenómenos de apoptosis. Los efectos colaterales pueden ser agudos o crónicos; los agudos, se postula, son secundarios a cambios en la estructura de la mucosa, el transporte epitelial y la actividad motora; los efectos crónicos pueden deberse a trastornos circulatorios u obstrucción linfática. Las alteraciones anteriores pueden producir ulceraciones, fístulas, fibrosis, estenosis, hemorragias y ocasionalmente perforaciones. Los cambios en la composición corporal están aún por clarificarse, pues son pocos los estudios que reportan el efecto de la radioterapia pélvica sobre el estado nutricional en la fase aguda o en la crónica. Se necesitan investigaciones en este campo con el fin de plantear estrategias para realizar el diagnóstico de la enteritis actínica en forma oportuna, aplicar tratamientos efectivos y establecer medidas preventivas en las pacientes que se someten a radioterapia pélvica para el tratamiento del cáncer ginecológico.

Palabras clave


Radioterapia; cáncer ginecológico; enteritis actínica; permeabilidad; radicales libres; apoptosis; respuesta inmunológica.

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Referencias


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