Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
Br J Cancer. 2011 Sep 6;105(6):737-45. doi: 10.1038/bjc.2011.315. Epub 2011 Aug 16.
We surveyed the occurrence of physical symptoms among long-term gynaecological cancer survivors after pelvic radiation therapy, and compared with population-based control women.
We identified a cohort of 789 eligible gynaecological cancer survivors treated with pelvic radiation therapy alone or combined with surgery in Stockholm or Gothenburg, Sweden. A control group of 478 women was randomly sampled from the Swedish Population Registry. Data were collected through a study-specific validated postal questionnaire with 351 questions concerning gastrointestinal and urinary tract function, lymph oedema, pelvic bones and sexuality. Clinical characteristics and treatment details were retrieved from medical records.
Participation rate was 78% for gynaecological cancer survivors and 72% for control women. Median follow-up time after treatment was 74 months. Cancer survivors reported a higher occurrence of symptoms from all organs studied. The highest age-adjusted relative risk (RR) was found for emptying of all stools into clothing without forewarning (RR 12.7), defaecation urgency (RR 5.7), difficulty feeling the need to empty the bladder (RR 2.8), protracted genital pain (RR 5.0), pubic pain when walking indoors (RR 4.9) and erysipelas on abdomen or legs at least once during the past 6 months (RR 3.6). Survivors treated with radiation therapy alone showed in general higher rates of symptoms.
Gynaecological cancer survivors previously treated with pelvic radiation report a higher occurrence of symptoms from the urinary and gastrointestinal tract as well as lymph oedema, sexual dysfunction and pelvic pain compared with non-irradiated control women. Health-care providers need to actively ask patients about specific symptoms in order to provide proper diagnostic investigations and management.
我们调查了盆腔放射治疗后长期妇科癌症幸存者的身体症状发生情况，并与基于人群的对照女性进行了比较。
我们确定了一个队列，其中包括 789 名在斯德哥尔摩或哥德堡接受盆腔放射治疗单独或联合手术治疗的妇科癌症幸存者。对照组 478 名女性是从瑞典人口登记处随机抽取的。数据通过专门的研究验证后的邮寄问卷收集，问卷包含 351 个问题，涉及胃肠道和泌尿系统功能、淋巴水肿、骨盆和性生活。临床特征和治疗细节从病历中检索。
妇科癌症幸存者的参与率为 78%，对照组女性为 72%。治疗后中位随访时间为 74 个月。癌症幸存者报告了所有研究器官的症状发生率更高。最高的年龄调整相对风险（RR）见于所有粪便排空到衣物中而无预警（RR 12.7）、排便急迫（RR 5.7）、难以感觉到需要排空膀胱（RR 2.8）、持续的生殖器疼痛（RR 5.0）、室内行走时耻骨疼痛（RR 4.9）和过去 6 个月至少一次腹部或腿部丹毒（RR 3.6）。单独接受放射治疗的幸存者一般表现出更高的症状发生率。
与未接受放射治疗的对照女性相比，以前接受盆腔放射治疗的妇科癌症幸存者报告称，在泌尿系统和胃肠道以及淋巴水肿、性功能障碍和骨盆疼痛方面，症状的发生率更高。医疗保健提供者需要积极询问患者特定症状，以便提供适当的诊断检查和管理。
