妇科恶性肿瘤扩展野放疗致放射性呕吐：剂量学与非剂量学因素
Radiation-Induced Emesis (RIE) in Extended-Field Radiotherapy for Gynecological Malignancies: Dosimetric and Non-Dosimetric Factors.
机构信息
Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
School of Traditional Chinese Medicine, Chang Gung University, Kaohsiung 33302, Taiwan.
出版信息
Curr Oncol. 2021 Sep 17;28(5):3602-3609. doi: 10.3390/curroncol28050308.
Radiation-induced emesis (RIE) is usually noted during abdominal-pelvic radiotherapy. In gynecological malignancies, it is usually noted in para-aortic but not whole-pelvic irradiation. Irradiated small bowel (SB) may be associated with RIE. The significance of SB dosimetry remains unclear. Dosimetric and non-dosimetric factors were evaluated and correlated with RIE in 45 patients with gynecological malignancies undergoing extended-field radiotherapy (EFRT) (median 45 Gy) from 2006 to 2021. Early-onset RIE (within 72 h after the first fraction of EFRT) was noted in 10 of 12 RIE patients. RIE was significantly associated with the SB mean dose. The RIE rates were 58.3% and 15.2% ( = 0.007) in patients with a low (<63%) and high (≥63%) SB mean dose. Logistic regression revealed that the SB mean dose remained the independent factor of overall RIE ( = 0.049) and early-onset RIE ( = 0.014). Therefore, constraint of the SB mean dose limited to less than 63% of the prescribed dose is suggested to decrease RIE.
辐射诱导呕吐（RIE）通常在腹部-骨盆放疗期间出现。在妇科恶性肿瘤中，它通常在主动脉旁照射而不是全骨盆照射时出现。照射小肠（SB）可能与 RIE 有关。SB 剂量学的意义仍不清楚。评估了剂量学和非剂量学因素，并与 2006 年至 2021 年期间接受扩展野放疗（EFRT）（中位数 45 Gy）的 45 例妇科恶性肿瘤患者的 RIE 相关。在 12 例 RIE 患者中，有 10 例在 EFRT 第一部分后 72 小时内出现早发性 RIE。RIE 与 SB 平均剂量显著相关。SB 平均剂量较低（<63%）和较高（≥63%）的患者的 RIE 发生率分别为 58.3%和 15.2%（=0.007）。逻辑回归显示，SB 平均剂量仍然是总体 RIE（=0.049）和早发性 RIE（=0.014）的独立因素。因此，建议将 SB 平均剂量限制在规定剂量的 63%以下，以减少 RIE。
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