**Part 5**

**Radiation Induced Effects and Overcoming Strategies**

246 Modern Practices in Radiation Therapy

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Zackheim, H.S., et al., *Relative frequency of various forms of primary cutaneous lymphomas.* J Am

Zochling, N., et al., *Human herpesvirus 8-specific DNA sequences in primary cutaneous B-cell* 

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*lymphomas.* Arch Dermatol, 1998. 134(2): p.246-7.

**13** 

*France* 

**The Stomach** 

Mineur Laurent, Jaegle Enric, Pourel Nicolas and Garcia Robin

*Institut Sainte Catherine Avignon,* 

*Gastrointestinal and Liver Oncology-Radiotherapy Unit* 

**Critical Normal Tissue and Radiation Injury:** 

There is limited detailed information regarding morbidity and toxicity following radiation treatment in gastric cancer. The curative effectivity of external radiotherapy necessitates exposure of normal tissues with significant radiation doses, and hence must be associated with an accepted rate of side effects. Based on the time of first treatment, complications can range from the acute side effects of external beam radiation therapy which resolve shortly after treatment to those that develop 6 months to 2 years after completion radiotherapy.

Anatomically stomach is divided into 4 regions: the cardiac region is surrounded by esophageal sphincter. The fundus lies against the diaphragm.Body (corpus) ensue from fundus and pylorus (pyloric antrum): ends at the pyloric sphincter which is a thickening of

Mucous secreting cells (goblet cells) line the luminal surface of the stomach and gastric pits and gastric glands which produce mucus and bicarbonate. Mucous neck cells are present in the neck of the gland andproduce mucin. Parietal cells (oxyntic cells) are distributed throughout the length of the gland, but numerous in the middle portion. Large, rounded cells with eosinophilic cytoplasm and centrally located nucleus. Chief cells (peptic or zymogenic cells) produce gastric acid. They are clustered at the base of the gland and identified by basally located nuclei and strongly basophilic granular cytoplasm. They

The gastric mucosa consists of surface epithelium, gastric pits and gastric glands. The gastric glands extend from the muscular mucosae to extend into the stomach lumen via gastric

**2. An outline of anatomy and normal histology of the stomach** 

**1. Introduction** 

**2.1 Anatomy** 

the muscle walls. (figure 1 et 2)

**2.2 Types of cells present in the stomach** 

produce pepsinogen, which digests protein.

**2.3 Normal histological features** 
