Which is the best? Palliative Radiation Therapy to Spleen or Splenectomy

Main Article Content

Yasemin Benderli Cihan

Abstract

Spleen is one of the most important organ of the reticuloendothelial system and coordinates the immune response. Splenectomy is performed for hypersplenism, and staging of hematological malignancy. In conservatively followed patients, radiation therapy can be used to reduce hypersplenism symptoms. Splenectomy or palliative radiotherapy to spleen may probably cause an immune suppressive condition. This may probably local and systemic complications.

Article Details

Cihan, Y. B. (2018). Which is the best? Palliative Radiation Therapy to Spleen or Splenectomy. Journal of Radiology and Oncology, 2(1), 003–008. https://doi.org/10.29328/journal.jro.1001015
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Mogestern L. A history of splenectomy, in Hiatt JR, Philips EH, Morgenstern L (eds): sutgical Diseases of the S pleen. Berlin-Heidelberg-Verlag. 1997; 3.

Mebius RE, Kraal G. Structure and function of the spleen. Nature Rev Immunol. 2005; 5: 606-616. Ref.: https://goo.gl/yz37Qi

Bowdler AJ (editör). The Complete Spleen: Structure, Function, and clinical Disorders. Humana Press, Totowa, NJ (2nd edition). 2002; 140: 18-47.

Rubin LG, Schaffner W. Clincial practice. Care of the asplenic patient. N Eng J Med. 2014; 371: 349-56. Ref.: https://goo.gl/wZ3UW2

Altamura M, Caradonna L, Amati L, Pellegrino NM, Urgesi G, et al. Splenectomy and sepsis: the role of the spleen in the immune-mediated bacterial clearance. Immunopharmacol Immunotoxicol. 2001; 23: 153-61. Ref.: https://goo.gl/p63YLC

Cihan YB, Yokus O, Mutlu H. The role of palliative radiotherpy in symptomatic splenomegaly developing among elderly patients with chronic myleoproliferative disorders. Turkish Journal of Geriatrics. 2012; 15: 34-39.

Wardemann H, Boehm T, Dear N, Carsetti R. B-1a B cells that link the innate and adaptive immune responses are lacking in the absence of the spleen. The Journal of Experimental Medicine. 2002; 195: 771. Ref.: https://goo.gl/8YzkKy

Pozo AL, Godfrey EM, Bowles KM. Splenomegaly: investigation, diagnosis and management. Blood Rev. 2009; 23: 105-111. Ref.: https://goo.gl/a9u19a

Di Sabatino A, Carsetti R, Corazza GR. Post-splenectomy and hyposplenic states. Lancet. 2011; 378: 86-97. Ref.: https://goo.gl/btiRav

Ziemski JM, Rudowsi WJ. Evaluation of early postsplenektomy complications. Surg Gyne Obs. 1987; 165: 507-515.

Rogers ZR, Wang WC, Luo Z, Iyer RV, Shalaby-Rana E, et al. Biomarkers of splenic function in infants with sickle cell anemia: baseline data from the BABY HUG Trial. Blood. 2011; 117: 2614-2617. Ref.: https://goo.gl/VVbd8v

Bronte V, Pittet MJ. The spleen in local and systemic regulation of immunity. Immunity. 2013; 39: 806-818. Ref.: https://goo.gl/KakxSU

Trip AK, Sikorska K, van Sandick JW, Heeg M, Cats A, et al. Radiation-induced dose-dependent changes of the spleen following postoperative chemoradiotherapy for gastric cancer. Radiother Oncol. 2015; 116: 239-244. Ref.: https://goo.gl/qUEaJs

Schwartz PE, Sterioff S, Mucha P, Melton 3rd LJ, Offord KP. Postsplenectomy sepsis and mortality in adults. JAMA. 1982; 248: 2279-2283. Ref.: https://goo.gl/FQcqRv

Wen SW, Everitt SJ, Bedő J, Chabrot M, Ball DL, et al. Spleen Volume Variation in Patients with Locally Advanced Non-Small Cell Lung Cancer Receiving Platinum-Based Chemo-Radiotherapy. PLoS One. 2015; 10: 0142608. Ref.: https://goo.gl/9fwLuN

Molrine DC, Siber GR, Samra Y, Shevy DS, MacDonald K, et al. Normal IgG and impaired IgM responses to polysaccharide vaccines in asplenic patients. Journal of Infectious Diseases. 1999; 179: 513-517. Ref.: https://goo.gl/CMAkWL

Davies J, Barnes R, Milligan D. Update of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen. Clinical Medicine. Clin Med (Lond). 2002; 2: 440-443. Ref.: https://goo.gl/azcNWK

Newland A, Provan D, Myint S. Preventing severe infection after splenectomy: Patients should know the risks, be immunised, and take prophylactic antibiotics. BMJ: British Medical Journal. 2005; 331: 417. Ref.: https://goo.gl/nGp9au

Styrt B. Infection associated with asplenia: risks, mechanisms, and prevention. Am J Med. 1990; 88: 33-42. Ref.: https://goo.gl/uPMqmV

Appelbaum PC. Antimicrobial resistance in Streptococcus pneumoniae: an overview. Clin Infect Dis. 1992; 15: 77-83. Ref.: https://goo.gl/GcZTXc

Kuranaga N, Kinoshita M, Kawabata T, Shinomiya N, Seki S. A defective Th1 response of the spleen in the initial phase may explain why splenectomy helps prevent a Listeria infection. Clinical & Experimental Immunology. 2005; 140: 11-21. Ref.: https://goo.gl/NuiLAq

Maus UA, Waelsch K, Kuziel WA, Delbeck T, Mack M, et al. Monocytes are potent facilitators of alveolar neutrophil emigration during lung inflammation: role of the CCL2-CCR2 axis. J Immunol. 2003; 170: 3273-3278. Ref.: https://goo.gl/sE7DzW

Barroso DE, Godoy D, Castiñeiras TMPP, Tulenko MM, Rebelo MC, et al. β-lactam Resistance, Serotype Distribution, and Genotypes of Meningitis causing Streptococcus pneumoniae, Rio de Janeiro, Brazil. The Pediatric İnfectious Disease Journal. 2012; 31: 30. Ref.: https://goo.gl/zCsCzm

Weinmann M, Becker G, Einsele H, Bamberg M. Clinical indications and biological mechanisms of splenic irradiation in chronic leukaemias and myeloproliferative disorders. Radiother Oncol. 2001; 58: 235-246. Ref.: https://goo.gl/HcErhi

Paulino AC, Reddy SP. Splenic irradiation in the palliation of patients with lymphoproliferative and myeloproliferative disorders. Am J Hosp Palliat Care. 1996; 13: 32-35. Ref.: https://goo.gl/ZPQxCK

Bouabdallah R, Coso D, Gonzague-Casabianca L, et al. Safety and efficacy of splenic irradiation in the treatment of patients with idiopathic myelofibrosis: a report on 15 patients. Leukemia Research. 2000; 24: 491-495.

Dailey MO, Coleman CN, Kaplan HS. Radiation-induced splenic atrophy in patients with Hodgkin’s disease and non-Hodgkin’s lymphomas. N Engl J Med. 1980; 302: 215-217. Ref.: https://goo.gl/bAaGAX

Wagner H, McKeough PG, Desforges J, MadocJones H. Splenic irradiation in the treatment of patients with chronic myelogenous leukemia or myelofibrosis with myeloid metaplasia: results of daily and intermittent fractionation with and without concomitant hydroxyurea. Cancer. 1986; 58: 1207. Ref.: https://goo.gl/AnQACg

Murray RG. The spleen. Histopathology of Irradiation (W. Bloom ed.) p.243. McGraw-Hill; New York. 1948.

Spencer RP, Pearson HA. Splenic radiocolloid uptake in the presence of circulating Howell-Jolly bodies. J Nucl Med. 1973; 15: 294-295. Ref.: https://goo.gl/KgAAuT

Looareesuwan S, Suntharasamai P, Webster HK, Ho M. Malaria in splenectomized patients: report of four cases and review. Clin Infect Dis. 1993; 16: 361-366. Ref.: https://goo.gl/yvGj24

Coleman CN, McDougall IR, Dailey MO, Ager P, Bush S, et al. Stanford, California. Functional Hyposplenia After Splenic Irradiation for Hodgkin's Disease. Ann Intern Med. 1982; 96: 44-47. Ref.: https://goo.gl/NF1mKT

Paulino AC, Reddy SP. Splenic irradiation in the palliation of patients with lymphoproliferative and myeloproliferative disorders. Am J Hosp Palliat Care. 1996; 13: 32-35. Ref.: https://goo.gl/8ZmDyN

Weinmann M, Becker G, Einsele H, Bamberg M. Clinical indications and biological mechanisms of splenic irradiation in chronic leukaemias and myeloproliferative disorders. Radiother Oncol. 2001; 58: 235-246. Ref.: https://goo.gl/TE3qcH

de Porto AP, Lammers AJ, Bennink RJ, ten Berge IJ, Speelman P, et al. Assessment of splenic function. Eur J Clin Microbiol Infect Dis. 2010; 29: 1465-1473. Ref.: https://goo.gl/Bz33J9

McFarland JT, Kuzma C, Millard FE, Johnstone PA. Palliative irradiation of the spleen. Am J Clin Oncol. 2003; 26: 178-183. Ref.: https://goo.gl/zSni8u

Elliott MA, Chen MG, Silverstein MN, Tefferi A. Splenic irradiation for symptomatic splenomegaly associated with myelofibrosis with myeloid metaplasia. Br J Hematol. 1998; 103: 505. Ref.: https://goo.gl/eLZKGU

Permentier C, Charbord P, Tibi M, Tubiana M. Splenic irradiation in myelofibrosis. Clinical findings and ferrokinetics. Int J Radiat Oncol Biol Phys. 1977; 2: 1075. Ref.: https://goo.gl/joAwxk

Crary SE, Buchanan GR. Vascular complications after splenectomy for hematologic disorders. Blood. 2009; 114: 2861-2868. Ref.: https://goo.gl/HmEk5q

Dailey MO, Coleman CN, Kaplan HS. Radiation-induced splenic atrophy in patients with Hodgkin’s disease and non-Hodgkin’s lymphomas. N Engl J Med. 1980; 302: 215-217. Ref.: https://goo.gl/mDTN8c

Ugel S, Peranzoni E, Desantis G, Chioda M, Walter S, et al. Immune tolerance to tumor antigens occurs in a specialized environment of the spleen. Cell Rep. 2012; 2: 628-639. Ref.: https://goo.gl/frXK9Q

Srisajjakul S, Prapaisilp P, Laorratkul N. Normal Splenic Volume Assessment on CT in 426 Adults. Siriraj Medical Journal. 2012; 64: 43-46.

Gatenby PA, Mudan SS, Wotherspoon AC. Splenectomy for non-haematological metastatic malignant disease. Langenbecks Arch Surg. 2011; 396: 625-638. Ref.: https://goo.gl/huWxaQ

Weinmann M, Becker G, Einsele H, Bamberg M. Clinical Indications and Biological Mechanisms of Splenic Irradiation in Autoimmune Diseases. Strahlentherapie und Onkologie January. 2001; 177: 105-111. Ref.: https://goo.gl/ELU5n9

Markus H, Forfar JC. Splenic irradiation in treating warm autoimmune hemolytic anaemia. Br Med J Clin Res Ed. 1986; 293: 839-840. Ref.: https://goo.gl/eHEgr7