open access

Vol 16, No 4 (2011)
Special Issue Papers
Published online: 2011-07-01
Submitted: 2011-03-08
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Medical management of the acute radiation syndrome

Mario López, Margarita Martín
DOI: 10.1016/j.rpor.2011.05.001
·
Rep Pract Oncol Radiother 2011;16(4):138-146.

open access

Vol 16, No 4 (2011)
Special Issue Papers
Published online: 2011-07-01
Submitted: 2011-03-08

Abstract

The acute radiation syndrome (ARS) occurs after whole-body or significant partial-body irradiation (typically at a dose of >1[[ce:hsp sp="0.25"/]]Gy). ARS can involve the hematopoietic, cutaneous, gastrointestinal and the neurovascular organ systems either individually or in combination.

There is a correlation between the severity of clinical signs and symptoms of ARS and radiation dose. Radiation induced multi-organ failure (MOF) describes the progressive dysfunction of two or more organ systems over time. Radiation combined injury (RCI) is defined as radiation injury combined with blunt or penetrating trauma, burns, blast, or infection. The classic syndromes are: hematopoietic (doses >2–3[[ce:hsp sp="0.25"/]]Gy), gastrointestinal (doses 5–12[[ce:hsp sp="0.25"/]]Gy) and cerebrovascular syndrome (doses 10–20[[ce:hsp sp="0.25"/]]Gy). There is no possibility to survive after doses >10–12[[ce:hsp sp="0.25"/]]Gy.

The Phases of ARS are—prodromal: 0–2 days from exposure, latent: 2–20 days, and manifest illness: 21–60 days from exposure.

Granulocyte-colony stimulating factor (G-CSF) at a dose of 5[[ce:hsp sp="0.25"/]]μg/kg body weight per day subcutaneously has been recommended as treatment of neutropenia, and antibiotics, antiviral and antifungal agents for prevention or treatment of infections.

If taken within the first hours of contamination, stable iodine in the form of nonradioactive potassium iodide (KI) saturates iodine binding sites within the thyroid and inhibits incorporation of radioiodines into the gland.

Finally, if severe aplasia persists under cytokines for more than 14 days, the possibility of a hematopoietic stem cell (HSC) transplantation should be evaluated.

This review will focus on the clinical aspects of the ARS, using the European triage system (METREPOL) to evaluate the severity of radiation injury, and scoring groups of patients for the general and specific management of the syndrome.

Abstract

The acute radiation syndrome (ARS) occurs after whole-body or significant partial-body irradiation (typically at a dose of >1[[ce:hsp sp="0.25"/]]Gy). ARS can involve the hematopoietic, cutaneous, gastrointestinal and the neurovascular organ systems either individually or in combination.

There is a correlation between the severity of clinical signs and symptoms of ARS and radiation dose. Radiation induced multi-organ failure (MOF) describes the progressive dysfunction of two or more organ systems over time. Radiation combined injury (RCI) is defined as radiation injury combined with blunt or penetrating trauma, burns, blast, or infection. The classic syndromes are: hematopoietic (doses >2–3[[ce:hsp sp="0.25"/]]Gy), gastrointestinal (doses 5–12[[ce:hsp sp="0.25"/]]Gy) and cerebrovascular syndrome (doses 10–20[[ce:hsp sp="0.25"/]]Gy). There is no possibility to survive after doses >10–12[[ce:hsp sp="0.25"/]]Gy.

The Phases of ARS are—prodromal: 0–2 days from exposure, latent: 2–20 days, and manifest illness: 21–60 days from exposure.

Granulocyte-colony stimulating factor (G-CSF) at a dose of 5[[ce:hsp sp="0.25"/]]μg/kg body weight per day subcutaneously has been recommended as treatment of neutropenia, and antibiotics, antiviral and antifungal agents for prevention or treatment of infections.

If taken within the first hours of contamination, stable iodine in the form of nonradioactive potassium iodide (KI) saturates iodine binding sites within the thyroid and inhibits incorporation of radioiodines into the gland.

Finally, if severe aplasia persists under cytokines for more than 14 days, the possibility of a hematopoietic stem cell (HSC) transplantation should be evaluated.

This review will focus on the clinical aspects of the ARS, using the European triage system (METREPOL) to evaluate the severity of radiation injury, and scoring groups of patients for the general and specific management of the syndrome.

Get Citation

Keywords

Acute radiation syndrome; Radiation injury; Radiation exposure; Nuclear accident

About this article
Title

Medical management of the acute radiation syndrome

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 16, No 4 (2011)

Pages

138-146

Published online

2011-07-01

DOI

10.1016/j.rpor.2011.05.001

Bibliographic record

Rep Pract Oncol Radiother 2011;16(4):138-146.

Keywords

Acute radiation syndrome
Radiation injury
Radiation exposure
Nuclear accident

Authors

Mario López
Margarita Martín

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