Yeoh E K, Horowitz M
Department of Radiation Oncology, Royal Adelaide Hospital, North Terrace, South Australia.
Surg Gynecol Obstet. 1987 Oct;165(4):373-9.
Acute radiation enteritis is almost inevitable in the curative treatment of malignant tumors of the abdomen and pelvic area. It is frequently a self-limiting disorder of intestinal function associated with reversible mucosal changes of the intestine. The prevalence of chronic radiation enteritis has been underestimated in most surgical series and the majority of patients with symptoms probably do not seek medical advice until a serious complication occurs. Although associated with specific histologic features, the mechanism of chronic radiation injury is poorly understood. The prevalence, pathogenesis, diagnosis and approaches to the treatment and prevention of acute and chronic radiation enteritis are discussed herein. Recent investigative techniques should lead to a better understanding of the physiopathologic characteristics of radiation enteritis and, thereby, provide a more rational basis for treatment which, at the present time, is unsatisfactory. Attempts to reduce the prevalence of radiation enteritis should be directed toward careful patient selection for radiation treatment of the pelvis and to minimize injury to the small intestine, by reducing the volume of small intestine in the radiation area and providing more individualized dosimetry.
急性放射性肠炎在腹部和盆腔恶性肿瘤的根治性治疗中几乎不可避免。它通常是一种肠道功能的自限性疾病，伴有肠道黏膜的可逆性改变。在大多数外科病例系列中，慢性放射性肠炎的患病率被低估了，大多数有症状的患者可能直到出现严重并发症才寻求医疗建议。虽然慢性放射性损伤与特定的组织学特征有关，但其机制仍知之甚少。本文讨论了急性和慢性放射性肠炎的患病率、发病机制、诊断以及治疗和预防方法。最近的研究技术应能使人们更好地了解放射性肠炎的生理病理特征，从而为目前并不理想的治疗提供更合理的依据。降低放射性肠炎患病率的努力应针对仔细选择接受盆腔放射治疗的患者，并通过减少放射区域内小肠的体积和提供更个体化的剂量测定来尽量减少对小肠的损伤。
