Division of Colon and Rectal Surgery, University of California-San Francisco, San Francisco, CA, USA.
Gastroenterol Clin North Am. 2013 Dec;42(4):913-25. doi: 10.1016/j.gtc.2013.08.004.
Radiation damage to the rectum following radiotherapy for pelvic malignancies can range from acute dose-limiting side effects to major morbidity affecting health-related quality of life. No standard guidelines exist for diagnosis and management of radiation proctitis. This article reviews the definitions, staging, and clinical features of radiation proctitis, and summarizes the modalities available for the treatment of acute and chronic radiation proctitis. Because of the paucity of well-controlled, blinded, randomized studies, it is not possible to fully assess the comparative efficacy of the different approaches to management. However, the evidence and rationale for use of the different strategies are presented.
盆腔恶性肿瘤放疗后直肠的放射性损伤范围从急性剂量限制的副作用到严重影响生活质量的主要发病率。目前尚无诊断和治疗放射性直肠炎的标准指南。本文回顾了放射性直肠炎的定义、分期和临床特征,并总结了治疗急性和慢性放射性直肠炎的各种方法。由于缺乏良好对照、盲法、随机研究,因此无法全面评估不同治疗方法的比较疗效。然而,本文介绍了不同策略的证据和原理。