[Radiation sequelae of the pancreas]

The pancreas has been considered a radioresistant organ for a long time. This classification originates in absence of clinical symptoms or in the vague position of the organ within the symptom-complex of radiogenic malabsorption after pancreas irradiation. Experiments with animals show considerable alterations after irradiation yet, especially in ultrastructural sphere. These disorders appear to be altered qualitatively after fractionated radioexposure: whereas in high single doses the parenchymatous part is affected more, in severe small single doses in area of small vessels with relatively early fibrotic alteration more severe alterations are described by different investigators. Alterations in parenchymatous structures of pancreas are capable of regression. Nevertheless it is not explained till now, why lasting pancreas-enzyme reduction can develop after a longer period. The great compensatory ability of pancreas results in merely non-essential enzyme alterations in serum as a rule in small-fractionated irradiation of upper abdomen. Unanimously all investigators find a small or no impairment of island cell apparatus after irradiation. Continuation of studies on radiogenic impairment of pancreas seems to be required earnestly, in particular in investigations of different fractionation rhythm too. However it renders more difficult by the problem to mark off clear endpoint-criteria.