Fuccio Lorenzo, Frazzoni Leonardo, Guido Alessandra
Lorenzo Fuccio, Leonardo Frazzoni, Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, University of Bologna, 40136 Bologna, Italy.
World J Gastrointest Pharmacol Ther. 2015 Feb 6;6(1):1-9. doi: 10.4292/wjgpt.v6.i1.1.
Pelvic cancers are among the most frequently diagnosed cancers worldwide. Treatment of patients requires a multidisciplinary approach that frequently includes radiotherapy. Gastrointestinal (GI) radiation-induced toxicity is a major complication and the transient or long-term problems, ranging from mild to very severe, arising in non-cancerous tissues resulting from radiation treatment to a tumor of pelvic origin, are actually called as pelvic radiation disease. The incidence of pelvic radiation disease changes according to the radiation technique, the length of follow up, the assessment method, the type and stage of cancer and several other variables. Notably, even with the most recent radiation techniques, i.e., intensity-modulated radiotherapy, the incidence of radiation-induced GI side effects is overall reduced but still not negligible. In addition, radiation-induced GI side effects can develop even after several decades; therefore, the improvement of patient life expectancy will unavoidably increase the risk of developing radiation-induced complications. Once developed, the management of pelvic radiation disease may be challenging. Therefore, the prevention of radiation-induced toxicity represents a reasonable way to avoid a dramatic drop of the quality of life of these patients. In the current manuscript we provide an updated and practical review on the best available evidences in the field of the prevention of pelvic radiation disease.
盆腔癌是全球最常被诊断出的癌症之一。对患者的治疗需要多学科方法，其中常常包括放射治疗。胃肠道（GI）辐射诱发的毒性是一种主要并发症，由盆腔原发性肿瘤的放射治疗导致的非癌组织中出现的从轻度到非常严重的短期或长期问题，实际上被称为盆腔放射病。盆腔放射病的发病率会根据放射技术、随访时间、评估方法、癌症类型和分期以及其他几个变量而变化。值得注意的是，即使采用最新的放射技术，即调强放射治疗，辐射诱发的胃肠道副作用的发生率总体上有所降低，但仍然不可忽视。此外，辐射诱发的胃肠道副作用甚至可能在几十年后出现；因此，患者预期寿命的提高将不可避免地增加发生辐射诱发并发症的风险。一旦发生，盆腔放射病的管理可能具有挑战性。因此，预防辐射诱发的毒性是避免这些患者生活质量急剧下降的合理方法。在本手稿中，我们对预防盆腔放射病领域的最佳现有证据进行了更新且实用的综述。
