Zhonghua Wei Chang Wai Ke Za Zhi. 2021 Nov 25;24(11):937-949. doi: 10.3760/cma.j.cn441530-20210927-00387.
Radiation therapy plays a significant role in the integrated treatment for patients with pelvic malignancies, but may lead to radiation-induced rectal injury in some patients, which may affect their physical health and quality of life negatively. Patients with radiation-induced rectal injury are often complicated with pelvic multi-organ injury. Collaborative, multidisciplinary evaluation of pelvic injuries should be highlighted in clinical practices, including clinical, endoscopic, radiological and histopathologic evaluation. To determine the overall treatment strategy and develop individualized treatment strategy, it is necessary to assess the oncologic prognosis, severity and stage of radiation-induced rectal injury and clinical classification using different rating scales. Considering that the disease is self-limiting, non-surgical treatment should be performed for patients with early lesions, while surgical interventions should be performed as soon as possible for patients with severe complications. In terms of prevention of radiation-induced rectal injury, prevention should be targeted for patients at high risk of radiation-induced rectal injury through technique improvement, physical protection and drug prevention. This consensus aims to provide guidance for the clinical practice of radiation-induced rectal injury in China.
放射治疗在盆腔恶性肿瘤患者的综合治疗中发挥着重要作用，但在部分患者中可能导致放射性直肠损伤，这可能会对其身体健康和生活质量产生负面影响。放射性直肠损伤患者常合并盆腔多器官损伤。在临床实践中，应重视对盆腔损伤进行多学科协作评估，包括临床、内镜、影像学和组织病理学评估。为确定总体治疗策略并制定个体化治疗方案，有必要使用不同的评分量表评估放射性直肠损伤的肿瘤学预后、严重程度、分期及临床分类。鉴于该疾病具有自限性，对于早期病变患者应采取非手术治疗，而对于严重并发症患者应尽早进行手术干预。在预防放射性直肠损伤方面，应通过技术改进、物理防护和药物预防等措施，针对放射性直肠损伤高危患者进行预防。本共识旨在为我国放射性直肠损伤的临床实践提供指导。
