Sartori Enrico, Zanagnolo Vanna
Recenti Prog Med. 2003 Dec;94(12):562-7.
Reporting and scoring treatment complications in gynecological cancers is difficult because of the variety of normal tissues, anatomical structures and treatment disciplines involved, making it impossible to compare series of patients treated in different institutions even with the same strategy. An international group of experts developed a multidisciplinary database to identify, score and report early and late normal tissue damage regardless of treatment strategy. The Franco-Italian Glossary provides clinicians with a comprehensive tool for scoring and describing complications regardless of the type of treatment delivered. The widespread use of this Glossary should at last allow objective comparisons on the nature and intensity of complications in patients treated in different Centers and/or with different strategies. The urinary tract is confirmed as the dominant site of complications after radical surgery with or without radiotherapy. Among the urological complications, the changes in bladder capacity and compliance appear as one of the major problems for the patients. The attempt to tailor the radicality according to tumour and patients characteristics seems to be one of the strategies to reduce the incidence of complications and their severity after surgical treatment of cervical cancer. The association of radiotherapy with radical surgery is generally recognized as an important risk factor in the determination of organ complications through vascular and fibrotic damage.
由于涉及多种正常组织、解剖结构和治疗学科，报告和评分妇科癌症的治疗并发症很困难，这使得即使采用相同策略，也无法比较不同机构治疗的患者系列。一个国际专家小组开发了一个多学科数据库，以识别、评分和报告早期和晚期正常组织损伤，而不考虑治疗策略。法意词汇表为临床医生提供了一个全面的工具，用于对并发症进行评分和描述，而不管所采用的治疗类型如何。该词汇表的广泛使用最终应能对不同中心治疗的患者和/或采用不同策略治疗的患者的并发症性质和严重程度进行客观比较。无论有无放疗，泌尿系统都是根治性手术后并发症的主要发生部位。在泌尿系统并发症中，膀胱容量和顺应性的变化似乎是患者面临的主要问题之一。根据肿瘤和患者特征调整根治程度的尝试似乎是降低宫颈癌手术治疗后并发症发生率及其严重程度的策略之一。放疗与根治性手术联合通常被认为是通过血管和纤维化损伤确定器官并发症的一个重要危险因素。
