Medical management of radiation injuries: Current approaches

Occupational Medicine

Volumn 56, Issue 3, 2006, Pages 162-172

  Berger, M E ^a   Christensen, D M ^a   Lowry, P C ^a   Jones, O W ^a   Wiley, Albert A ^a  

^a Radiation Emergency Assistance Center/Training Site (REAC/TS)   (United States)

Author keywords

Combined injury; Gastrointestinal syndrome; Haematopoietic syndrome; Internal contamination; Local radiation injury; Radiation injury; Radiation medicine

Indexed keywords

ACETYLSALICYLIC ACID; ALOSETRON; ALUMINUM HYDROXIDE; ANALGESIC AGENT; ANTIBIOTIC AGENT; ANTIEMETIC AGENT; ANTIINFECTIVE AGENT; ANTIVIRUS AGENT; CASPOFUNGIN; CHOLINERGIC RECEPTOR BLOCKING AGENT; COLONY STIMULATING FACTOR; CYTOKINE; DOLASETRON MESILATE; ERYTHROPOIETIN; FLUCONAZOLE; GANCICLOVIR; GRANISETRON; HEMOPOIETIC GROWTH FACTOR; INTERLEUKIN 11; LOPERAMIDE; NEUROKININ 1 RECEPTOR ANTAGONIST; ONDANSETRON; PENICILLIN G; QUINOLINE DERIVED ANTIINFECTIVE AGENT; RECOMBINANT GRANULOCYTE COLONY STIMULATING FACTOR; RECOMBINANT GRANULOCYTE MACROPHAGE COLONY STIMULATING FACTOR; SEROTONIN 3 ANTAGONIST; TROPISETRON; UNINDEXED DRUG; VORICONAZOLE;

BACTERIAL INFECTION; BLEEDING; CELL KINETICS; DIGESTIVE SYSTEM INJURY; EARLY DIAGNOSIS; HEMATOLOGIC DISEASE; HEMATOPOIETIC STEM CELL TRANSPLANTATION; HUMAN; LABORATORY TEST; LYMPHOCYTE DEPLETION; MYCOSIS; NEUTROPENIA; PRIORITY JOURNAL; RADIATION DOSE; RADIATION INDUCED EMESIS; RADIATION INJURY; RADIATION SICKNESS; RADIOACTIVE CONTAMINATION; REVIEW; SKIN INJURY; SYMPTOMATOLOGY; TREATMENT PLANNING; VIRUS INFECTION;

ACCIDENTS, OCCUPATIONAL; ACCIDENTS, RADIATION; COLONY-STIMULATING FACTORS; HEMATOPOIETIC STEM CELL TRANSPLANTATION; HUMANS; OPPORTUNISTIC INFECTIONS; RADIATION DOSAGE; RADIATION INJURIES; RADIOACTIVE HAZARD RELEASE;

EID: 33646259011     PISSN: 09627480     EISSN: 14718405     Source Type: Journal    
DOI: 10.1093/occmed/kql011     Document Type: Review

References (66)

1. Guskova AK, Nadezhina NM, Moiseev AA et al. Medical assistance given to personnel of the Chernobyl nuclear power plant after the 1986 accident. Hematol Rev 1996;7:27-100.
2. Wasalenko JK, MacVittie TJ, Blakely WF et al. Medical management of the acute radiation syndrome: Recommendations of the Strategic National Stockpile Radiation Working Group. Ann Intern Med 2004;140:1037-1051.
3. Goans RE. Clinical care of the radiation-accident patient: Patient presentation, assessment and diagnosis. In: Ricks RC, Berger ME, O'Hara FM, eds. The Medical Basis for Radiation-Accident Preparedness: The Clinical Care of Victims. New York: Parthenon, 2002; 11-22.
4. Andrews G. Medical management of accidental total body irradiation. In: Hubner RF, Fry SF, eds. The Medical Basis for Radiation Accident Preparedness. New York: Elsevier North Holland Inc., 1980; 297-310.
5. Goans RE, Holloway EC, Berger ME, Ricks RC. Early dose assessment following severe radiation accidents. Health Phys 1997;72;513-518.
6. Goans RE, Holloway EC, Berger ME, Ricks RC. Early dose assessment in criticality accidents. Health Phys 2001;81:446-449.
7. AFRRI. Medical Management of Radiation Injuries: Current Approaches. http://www.afrri.usuhs.mil/ (14 December 2005, date last accessed).
8. Sine RC, Levine IH, Jackson WE et al. Biodosimetry assessment tool: A post-exposure software application for management of radiation accidents. Mil Med 2001;166 (12 Suppl.):85-87.
9. Guskova AK, Baranov AE, Gusev IA. Acute radiation sickness: Underlying principles and assessment. In: Gusev IA, Guskova AK, Mettler FA, eds. Medical Management of Radiation Accidents, 2nd edn. Boca Raton: CRC Press, 2001; 33-51.
10. Fliedner TM, Friesecke I, Beyer K, eds. Medical Management of Radiation Accidents: Manual on the Acute Radiation Syndrome. Oxford: British Institute of Radiology, 2001.
11. Anno GH, Baum SJ, Withers HR, Young RW. Symptomatology of acute radiation effects in humans after exposures to doses of 0.5-30 Gy. Health Phys 1989;56:821-838.
12. International Atomic Energy Agency. Diagnosis and Treatment of Radiation Injuries. Safety Report Series No. 2. Vienna: IAEA, 1998.
13. Hartman A, Bojar H, Zamboglou N, Pape H, Schnabel T, Schmitt G. The significance of clinical prodromes for dosage estimation after whole-body radiation exposure. Strahlenther Onkol 1994;170:538-544.
14. Chaillet MP, Cosset JM, Socie G et al. Prospective study of the clinical symptoms of therapeutic whole body irradiation. Health Phys 1993;64:370-374.
15. Dubray B, Girinski T, Thomas HD et al. Post-irradiation hyperamylasemia as a biological dosimeter. Radiother Oncol 1992;24:21-26.
16. Hofmann R, Schreiber GA, Willich N, Westhaus R, Bogl KW. Increased serum amylase in patients after radiotherapy as a probable bioindicator of a radiation exposure. Strahlenther Onkol 1990;166:688-695.
17. Hennequin C, Cosset JM, Cailleux PE et al. Blood amylase: A biological marker in irradiation accidents? Preliminary results obtained at the Gustave-Roussy Institut (GRI) and a literature review. Bull Cancer 1989;76: 617-624.
18. Murata H, Akashi M, eds. The Report of the Criticality Accident in a Uranium Conversion Test Plant in Tokai-Mura. Chiba, Japan: National Institute of Radiological Sciences (NIRS), 2002.
19. Akashi M. Initial symptoms of three victims in the Tokai-mura criticality accident. In: Ricks RC, Berger ME, O'Hara FM, eds. The Medical Basis for Radiation-Accident Preparedness. The Clinical Care of Victims. New York: Parthenon, 2002; 303-311.
20. Berger ME, Leonard RB, Ricks RC, Wiley AL, Lowry PC, Flynn DF. Hospital Triage in the First 24 Hours after a Nuclear or Radiological Disaster. REAC/TS. http://www.orau.gov/reacts (14 December 2005, date last accessed).
21. Fliedner TM, Friesecke I, Beyer K, eds. Medical Management of Radiation Accidents: Manual on the Acute Radiation Syndrome. Oxford: British Institute of Radiology, 2001; 21.
22. Conklin JJ, Walker RI. Diagnosis, triage, and treatment of casualties. In: Conklin JJ, Walker RI, eds. Military Radiobiology. Orlando, FL: Academic Press, Inc., 1987; 457-472.
23. Reeves GI. Radiation injuries. Critical Care Clinics Environ Emerg 1999;15:457-473.
24. DeWit R. Current position of 5HT3 antagonists and the additional value of NK1 antagonists; a new class of antiemetics. Br J Cancer 2003;88:1823-1827.
25. Cappell MS. Colonic toxicity of administered drugs and chemicals. Am J Gastroenterol 2004;99:1175-1190.
26. Moulder JE. Post-irradiation approaches to treatment of radiation injuries in the context of radiological terrorism and radiation accidents: A review. Int J Radiat Biol 2004;80:3-10.
27. Hughes WT. Use of antimicrobial agents in the treatment of infection in the neutropenic immunocompromised patient. In: Ricks RC, Berger ME, O'Hara FM, eds. The Medical Basis for Radiation Accident Preparedness: The Clinical Care of Victims. New York: Parthenon, 2002; 117-129.
28. Hughes WT, Armstrong D, Bodey GP et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis 2002;34:730-751.
29. Perfect JR. Management of invasive mycoses in hematology patients: current approaches; and use of newer anti-fungal therapies in clinical practice: What do the data tell us? Oncology 2004;18(Suppl. 7):5-14, 15-23.
30. Nagayama H, Ooi J, Tomonari A et al. Severe immune dysfunction after lethal neutron irradiation in a JCO nuclear facility accident victim. Int J Hematol 2002;76: 157-164.
31. Dainiak N. Hematological consequences of exposure to ionizing radiation. Exp Hematol 2002;30:513-525.
32. Tsimberidou AM, Giles FJ, Khouri I, Bueso-Ramos C, Pilat S, Thomas DA. Low-dose interleukin-11 in patients with bone marrow failure: Update of the M.D. Anderson Cancer Center experience. Ann Oncol 2005;16:139-145.
33. Cotreau MM, Stonis L, Strahs A, Schwertschlag US. A multiple-dose, safety, tolerability pharmacokinetics and pharmacodynamics study of oral recombinant human interleukin-11 (oprelvekin). Biopharm Drug Dispos 2004; 25:291-296.
34. Stokman MA, Spijkervet FK, Burlage FR et al. Oral mucositis and selective elimination of oral flora in head and neck cancer patients receiving radiotherapy: A double-blind randomized clinical trial. Br J Cancer 2003;88:1012-1016.
35. Sprinzl GM, Galvan O, deVries A et al. Local application of granulocyte-macrophage colony stimulating factor (GM-CSF) for the treatment of oral mucositis. Eur J Cancer 2001;37:2003-2009.
36. Makkonen TA, Minn H, Jekunen A, Vilja P, Joensuu H. Granulocyte macrophage-colony stimulating factor (GM-CSF) and sucralfate in prevention of radiation-induced mucositis: A prospective study. Int J Radiat Oncol Biol Phys 2000;46:525-534.
37. Cengiz M, Ozyar E, Ozturk D et al. Sucralfate in the prevention of radiation-induced mucositis. J Clin Gastroenterol 1999;28:40-43.
38. Freytes CO, Ratanatharathorn V, Taylor C et al. Phase I/II randomized trial evaluating the safety and clinical effects of repifermin administered to reduce mucositis in patients undergoing autologous hematopoietic stem cell transplantation. Clin Cancer Res 2004;10:8318-8324.
39. Spielberger R, Stiff P, Bensinger W et al. Palifermin for oral mucositis after intensive therapy for hematologic cancers. N Engl J Med 2004;351:2590-2598.
40. Sharp JG. The potential use of cytokines to ameliorate the effects of gastrointestinal radiation injury. In: MacVittie TJ, Weiss JF, Brown D, eds. Advances in the Treatment of Radiation Injuries. Proceedings of the 2nd Consensus Development Conference on the Treatment of Radiation Injuries. Oxford: Pergamon Elsevier Ltd., 1996; 217-231.
41. Gunter-Smith PJ, Dubois A. Treatment strategies for radiation-induced gastrointestinal injuries. In: MacVittie TJ, Weiss JF, Browne D, eds. Advances in the Treatment of Radiation Injuries. Tarrytown, NY: Pergamon, 1996; 195-200.
42. Otterson MF, Sarna SK, Moulder JE. The effects of radiation on gastrointestinal motility and potential therapies. In: MacVittie TJ, Weiss JF, Browne D, eds. Advances in the Treatment of Radiation Injuries. Tarrytown, NY: Pergamon, 1996; 207-216.
43. Potten CS. Radiation injury of the gastrointestinal epithelium: Current research on treatment, management, and prevention. In: Ricks RC, Berger ME, O'Hara FM, eds. The Medical Basis for Radiation - Accident Preparedness: The Clinical Care of Victims. New York: Parthenon, 2002; 139-148.
44. Paris F, Fuks Z, Kang A et al. Endothelial apoptosis as the primary lesion initiating intestinal radiation damage in mice. Science 2001;293:293-297.
45. Beck PL, Wong JF, Swaminathan S, Xavier RJ, Devaney KL, Podolsky DK. Chemotherapy - and radiotherapy-induced intestinal damage is regulated by intestinal trefoil factor. Gastroenterology 2004;126:796-808.
46. Lutgens LC, Deutz N, Granzier-Peters M et al. Plasma citrulline concentration: A surrogate end point for radiation-induced mucosal atrophy of small bowel. A feasibility study in 23 patients. Int J Radiat Oncol Biol Phys 2004;60:275-285.
47. McArdle AH. Protection from radiation injury by elemental diet: Does added glutamine change the effect? Gut 1994;35(1 Suppl.):60-64.
48. Fliedner TM, Frieseche I, Beyer K, eds. Medical Management of Radiation Accidents. Manual on the Acute Radiation Syndrome. Oxford: British Institute of Radiology, 2001; 51.
49. Ringden O, Labopin M, Gorin NC et al. Treatment with granulocyte colony stimulating factor after allogenic bone marrow transplantation for acute leukemia increases the risk of graft-versus-host-disease and death: A study from the acute leukemia working party of the European group for blood and marrow transplantation. J Clin Oncol 2004;22:416-423.
50. Storek J, Dawson MA, Storer B et al. Immune reconstitution from allogenic marrow transplantation compared with blood stem cell transplantation. Blood 2001;97: 3380-3389.
51. Liles WC, Rodger E, Broxmeyer HE et al. Augmented mobilization and collection of CD34+ hematopoietic cells from normal human volunteers stimulated with granulocyte-colony - stimulating factor by single-dose administration of AMD3100, a CXCR4 antagonist. Transfusion 2005; 45:295-300.
52. Devine SM, Flomenberg N, Vesole DH, Liesveld J, Weisdorf D, Badel K. Rapid mobilization of CD34+ cells following administration of the CXCR4 antagonist AMD3100 to patients with multiple myeloma and non-Hodgkin's lymphoma. J Clin Oncol 2004;22:1095-1102.
53. Rocha V, Labopin M, Sanz G et al. Transplants of umbilical-cord blood or bone marrow from unrelated donors in adults with acute leukemia. N Engl J Med 2004;351:2276-2285.
54. Davey S, Armitage S, Rocha V et al. The London Cord Blood Bank: Analysis of banking and transplantation outcome. Br J Hematol 2004;125:358-365.
55. Guskova AK, Nadezhina NM, Moiseev AA et al. Medical assistance given to personnel of the Chernobyl nuclear power plant after the 1986 accident. Hematol Rev 1996;7:75.
56. Barabanova AV. Acute radiation syndrome with cutaneous syndrome. In: Ricks RC, Berger ME, O'Hara FM, eds. The Medical Basis for Radiation Accident Preparedness: The Clinical Care of Victims. New York: Parthenon, 2002; 217-224.
57. International Atomic Energy Agency and World Health Organization. How to Recognize and Initially Respond to an Accidental Radiation Injury. Vienna, Austria: IAEA, 2000.
58. Koteles GJ, Benko I, Nemeth O. Use of thermography in diagnosis of local radiation injuries. Health Phys 1998; 74:264-265.
59. Peter RU, Gottlober P. Management of cutaneous radiation injuries: diagnostic and therapeutic principles of the cutaneous radiation syndrome. Mil Med 2000;167 (2 Suppl.):110-112.
60. Gonyon DL, Zenn MR. Simple approach to the radiated scalp wound using INTEGRA skin substitute. Ann Plast Surg 2003;50:315-320.
61. Peter RU. Management of skin injuries in radiation accidents: The cutaneous radiation syndrome. In: Ricks RC, Berger ME, O'Hara FM, eds. The Medical Basis for Radiation Accident Preparedness: The Clinical Care of Victims. New York: Parthenon, 2002; 225-229.
62. Hom DB, Manivel JC. Promoting healing with recombinant human platelet-derived growth factor-BB in a previously irradiated problem wound. Laryngoscope 2003;113:1566-1571.
63. Milanov NO, Shilov BL, Tjulenev AV. Surgical treatment of radiation injuries of the hand. Plast Reconstr Surg 1993;92:294-300.
64. Peter RU, Gottlober P, Nadeshina N, Krahn G, Braun-Falco O, Plewig O. Interferon gamma in survivors of the Chernobyl power plant accident: New therapeutic option for radiation induced fibrosis. Int J Radiat Oncol Biol Phys 1999;45:147-152.
65. Gottlober P, Steinert M, Bahren W, Weber L, Gerngross H, Peter RU. Interferon-gamma in patients with cutaneous syndrome after radiation therapy. Int J Radiat Oncol Biol Phys 2001;50:159-166.
66. National Council on Radiation Protection and Measureent. Management of Persons Accidentally Contaminated with Radionuclides. NCRP Report No. 65. Washington, DC, 1980.