Steineck Gunnar, Sjöberg Fei, Skokic Viktor, Bull Cecilia, Wilderäng Ulrica, Alevronta Eleftheria, Dunberger Gail, Bergmark Karin, Jörnsten Rebecka
a Division of Clinical Cancer Epidemiology, Department of Oncology , Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden.
b Department of Oncology and Pathology, Division of Clinical Cancer Epidemiology , Karolinska Institutet , Stockholm , Sweden.
Acta Oncol. 2017 May;56(5):682-691. doi: 10.1080/0284186X.2017.1307519. Epub 2017 Apr 1.
It is unknown whether smoking; age at time of radiotherapy or time since radiotherapy influence the intensity of late radiation-induced bowel syndromes.
We have previously identified 28 symptoms decreasing bowel health among 623 gynecological-cancer survivors (three to twelve years after radiotherapy) and 344 matched population-based controls. The 28 symptoms were grouped into five separate late bowel syndromes through factor analysis. Here, we related possible predictors of bowel health to syndrome intensity, by combining factor analysis weights and symptom frequency on a person-incidence scale.
A strong (p < .001) association between smoking and radiation-induced urgency syndrome was found with a syndrome intensity (normalized factor score) of 0.4 (never smoker), 1.2 (former smoker) and 2.5 (current smoker). Excessive gas discharge was also related to smoking (p = .001). Younger age at treatment resulted in a higher intensity, except for the leakage syndrome. For the urgency syndrome, intensity decreased with time since treatment.
Smoking aggravates the radiation-induced urgency syndrome and excessive gas discharge syndrome. Smoking cessation may promote bowel health among gynecological-cancer survivors. Furthermore, by understanding the mechanism for the decline in urgency-syndrome intensity over time, we may identify new strategies for prevention and alleviation.
放疗时的吸烟情况、年龄或放疗后的时间是否会影响晚期放射性肠综合征的严重程度尚不清楚。
我们之前在623名妇科癌症幸存者（放疗后三至十二年）和344名匹配的基于人群的对照中确定了28种降低肠道健康的症状。通过因子分析，将这28种症状分为五种不同的晚期肠道综合征。在此，我们通过在个体发病率量表上结合因子分析权重和症状频率，将肠道健康的可能预测因素与综合征严重程度相关联。
发现吸烟与放射性尿急综合征之间存在强烈关联（p < 0.001），综合征严重程度（标准化因子得分）分别为：从不吸烟者为0.4，既往吸烟者为1.2，当前吸烟者为2.5。排气过多也与吸烟有关（p = 0.001）。除了渗漏综合征外，治疗时年龄较小会导致更高的严重程度。对于尿急综合征，严重程度随治疗后的时间而降低。
吸烟会加重放射性尿急综合征和排气过多综合征。戒烟可能会促进妇科癌症幸存者的肠道健康。此外，通过了解尿急综合征严重程度随时间下降的机制，我们可能会确定预防和缓解的新策略。
