Department of Urologic Surgery, University of Minnesota, 420 Delaware St SE, MMC 394, Minneapolis, MN 55455, USA.
World J Urol. 2011 Feb;29(1):35-41. doi: 10.1007/s00345-010-0603-x. Epub 2010 Oct 20.
Radiation for tumors arising in the pelvis has been utilized for over a 100 years. Adverse effects (AEs) of radiotherapy (RT) continue to accumulate with time and are reported to show decades after treatment. The benefit of RT for pelvic tumors is well described as is their acute AEs. Late AEs are less well described. The burden of treatment for the late AEs is large given the high utilization of RT.
For prostate cancer, 37% of patients will receive radiation during the first 6 months after diagnosis. Low-and high-grade AEs are reported to occur in 20-43 and 5-13%, respectively, with a median follow-up of ~60 months. For bladder cancer, the grade 2 and grade 3 late AEs occur in 18-27 and 6-17% with a median follow-up of 29-76 months. For cervical cancer, the risk of low-grade AEs following radiation can be as high as 28%. High-grade AEs occur in about 8% at 3 years and 14.4% at 20 years or ~0.34% per year. Radiation AEs appear to be less common or at least less well studied after radiation for rectal and endometrial cancers.
Properly delineating the rate of long-term AEs after pelvic RT is instrumental to counseling patients about their options for cancer treatment. Further studies are needed that are powered to specifically evaluate long-term AEs.
盆腔肿瘤的放射治疗已经应用了 100 多年。放射治疗（RT）的不良反应（AE）随着时间的推移不断积累，并在治疗后数十年报告。盆腔肿瘤的 RT 益处以及其急性 AE 已有详细描述。而晚期 AE 则描述较少。鉴于 RT 的广泛应用，晚期 AE 的治疗负担很大。
对于前列腺癌，37%的患者在诊断后 6 个月内接受放射治疗。低级别和高级别 AE 的发生率分别为 20-43%和 5-13%，中位随访时间约为 60 个月。对于膀胱癌，2 级和 3 级晚期 AE 的发生率分别为 18-27%和 6-17%，中位随访时间为 29-76 个月。对于宫颈癌，放疗后低级别 AE 的风险高达 28%。高级别 AE 发生率为 3 年时约 8%，20 年时约 14.4%，即每年约 0.34%。在直肠癌和子宫内膜癌的放射治疗后，放射治疗的 AE 似乎较少见，或者至少研究较少。
正确描述盆腔 RT 后长期 AE 的发生率对于向患者提供癌症治疗方案至关重要。需要进一步研究，以专门评估长期 AE。
