Blanchard P, Chapet O
Département de Radiothérapie, Institut Gustave-Roussy, 114 Rue Edouard Vaillant, 94805 Villejuif, France.
Cancer Radiother. 2010 Jul;14(4-5):354-8. doi: 10.1016/j.canrad.2010.02.012. Epub 2010 May 31.
Radiation proctitis is among the most frequent radiation-induced toxicities. This is related to the high frequency of pelvic tumours and the key role of radiotherapy in the treatment of these tumours. Late rectal toxicity usually occurs within the first two years after the completion of a radiotherapy course. Rectal bleeding and a rectal syndrome are the main symptoms, and can be associated to fistulas or rectal ulcers. Clinical factors, such as diabetes mellitus, a severe acute radiation toxicity, small rectal volume or radiation hypersensitivity, are associated with late rectal toxicity. Dosimetric factors derived from the analysis of dose-volume histograms can also predict the occurrence of radiation proctitis, and help to adapt the prescribed dose and the ballistic of irradiation.
放射性直肠炎是最常见的辐射诱导毒性反应之一。这与盆腔肿瘤的高发病率以及放射治疗在这些肿瘤治疗中的关键作用有关。晚期直肠毒性通常发生在放疗疗程结束后的头两年内。直肠出血和直肠综合征是主要症状，可能与瘘管或直肠溃疡有关。临床因素，如糖尿病、严重的急性辐射毒性、直肠体积小或辐射超敏反应，与晚期直肠毒性有关。从剂量体积直方图分析得出的剂量学因素也可以预测放射性直肠炎的发生，并有助于调整处方剂量和照射弹道。
