Komori Koji, Kimura Kenya, Kinoshita Takashi, Sano Tsuyoshi, Ito Seiji, Abe Tetsuya, Senda Yoshiki, Misawa Kazunari, Ito Yuichi, Uemura Norihisa, Kawai Ryosuke, Shimizu Yasuhiro
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
Int Surg. 2014 Mar-Apr;99(2):100-5. doi: 10.9738/INTSURG-D-13-00200.1.
Preoperative management of advanced rectal cancer often includes chemoradiotherapy, but little is known about the late complications of radiotherapy. However, these are usually serious, making determination of the characteristics of late complications after radiation therapy critical. Accordingly, we investigated the complications occurring after adjuvant pelvic radiation therapy in patients with advanced rectal cancer. We enrolled 34 consecutive patients with TNM stage III rectal cancer who had undergone curative surgery with adjuvant pelvic radiation therapy. Data on the type of complication/organ involved, the number of complications, the phase of onset, and the treatments used were reviewed. Patients who experienced gut complications or edema were less likely to have their complications resolved than those with complications due to infection. Similarly, patients with multiple complications and late-onset complications were also less likely to have their complications resolved than those with single complications and those with early-onset complications, respectively. Adjuvant radiation therapy in patients with resected advanced rectal cancer was associated with various complications, characterized by late onset and impaired resolution. Therefore, patients indicated for radiation therapy should be selected with great caution.
晚期直肠癌的术前管理通常包括放化疗，但对于放疗的晚期并发症却知之甚少。然而，这些并发症通常较为严重，因此确定放疗后晚期并发症的特征至关重要。据此，我们对晚期直肠癌患者辅助盆腔放疗后出现的并发症进行了调查。我们纳入了34例连续的TNM III期直肠癌患者，这些患者均接受了根治性手术及辅助盆腔放疗。回顾了有关并发症/受累器官类型、并发症数量、发病阶段及所采用治疗方法的数据。出现肠道并发症或水肿的患者其并发症缓解的可能性低于因感染出现并发症的患者。同样，分别出现多种并发症和迟发性并发症的患者其并发症缓解的可能性也低于出现单一并发症和早发性并发症的患者。接受手术的晚期直肠癌患者的辅助放疗会引发各种并发症，其特点是发病较晚且缓解受损。因此，对于适合放疗的患者应谨慎选择。
