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放射性直肠损伤防治中国临床实践指南

Chinese clinical practice guidelines for the prevention and treatment of radiation-induced rectal injury.

作者信息

Zhang Hui, Zhang Zhen, Yuan Shuanghu

机构信息

Department of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai China.

China Anti-Cancer Association Tumor Support Therapy Committee.

出版信息

Precis Radiat Oncol. 2023 Dec 25;7(4):237-255. doi: 10.1002/pro6.1217. eCollection 2023 Dec.

DOI:10.1002/pro6.1217
PMID:40336868
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11935203/
Abstract

Although radiotherapy plays an important role in the treatment of cancer, it may have negative effects in some individuals. Rectal injury is a common adverse effect of abdominal and pelvic radiotherapy. This injury is caused by administering radiation to the abdomen. Appropriate treatment techniques can be determined if doctors have a better understanding of the incidence, risk factors, and clinical symptoms of radiation-induced rectal injuries. Studies on the underlying pathophysiology of radiation-induced rectal injury may aid in the development of effective treatment and prevention strategies. The implementation of efficient preventive measures can improve the quality of life of patients with cancer and make it easier for them to complete their treatment. Therefore, comprehensive and accurate assessments are crucial for developing holistic and individualized treatment plans for patients who have already developed symptoms, with early intervention being a priority.

摘要

尽管放射治疗在癌症治疗中起着重要作用,但在某些个体中可能会产生负面影响。直肠损伤是腹部和盆腔放射治疗的常见不良反应。这种损伤是由于对腹部进行辐射所致。如果医生能更好地了解放射性直肠损伤的发生率、危险因素和临床症状,就可以确定合适的治疗技术。对放射性直肠损伤潜在病理生理学的研究可能有助于制定有效的治疗和预防策略。实施有效的预防措施可以提高癌症患者的生活质量,使他们更容易完成治疗。因此,对于已经出现症状的患者,全面准确的评估对于制定整体和个性化的治疗方案至关重要,早期干预是重中之重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0ce/11935203/12a5c8b6de64/PRO6-7-237-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0ce/11935203/44b31fbbf0b8/PRO6-7-237-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0ce/11935203/12a5c8b6de64/PRO6-7-237-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0ce/11935203/44b31fbbf0b8/PRO6-7-237-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0ce/11935203/12a5c8b6de64/PRO6-7-237-g003.jpg

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本文引用的文献

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Hyperbaric oxygen treatment for late radiation-induced tissue toxicity in treated gynaecological cancer patients: a systematic review.高压氧治疗妇科癌症患者放疗后晚期组织毒性:系统评价。
Radiat Oncol. 2022 Oct 6;17(1):164. doi: 10.1186/s13014-022-02067-6.
2
Prediction models for brachytherapy-induced rectal toxicity in patients with locally advanced pelvic cancers: a systematic review.局部晚期盆腔癌患者近距离放疗所致直肠毒性的预测模型:一项系统评价
J Contemp Brachytherapy. 2022 Aug;14(4):411-422. doi: 10.5114/jcb.2022.119427. Epub 2022 Aug 31.
3
Novel mechanisms underlying inhibition of inflammation-induced angiogenesis by dexamethasone and gentamicin via PI3K/AKT/NF-κB/VEGF pathways in acute radiation proctitis.
地塞米松和庆大霉素通过 PI3K/AKT/NF-κB/VEGF 通路抑制急性放射性直肠炎中炎症诱导的血管生成的新机制。
Sci Rep. 2022 Aug 18;12(1):14116. doi: 10.1038/s41598-022-17981-8.
4
Rectal band ligation as a treatment for chronic radiation proctitis: a feasibility study.直肠套扎术治疗慢性放射性直肠炎的可行性研究
Endosc Int Open. 2022 Jun 10;10(6):E787-E790. doi: 10.1055/a-1821-0776. eCollection 2022 Jun.
5
The dynamic cellular and molecular features during the development of radiation proctitis revealed by transcriptomic profiling in mice.转录组谱分析揭示了小鼠放射性直肠炎发展过程中的动态细胞和分子特征。
BMC Genomics. 2022 Jun 9;23(1):431. doi: 10.1186/s12864-022-08668-5.
6
Intensity-Modulated Radiotherapy and Three-Dimensional Conformal Radiotherapy Combined with Intracavitary Posterior Radiotherapy for the Treatment of Medium-Term and Advanced Cervical Cancer: Efficacy, Safety and Prognostic Factors.调强放射治疗与三维适形放射治疗联合腔内后装放射治疗中晚期宫颈癌的疗效、安全性及预后因素
Front Surg. 2022 May 23;9:906117. doi: 10.3389/fsurg.2022.906117. eCollection 2022.
7
Study on Appropriate Rectal Volume for External Irradiation in Patients With Cervical Cancer.宫颈癌患者体外照射合适直肠容积的研究
Front Oncol. 2022 Feb 22;12:814414. doi: 10.3389/fonc.2022.814414. eCollection 2022.
8
Patient-related risk factors for late rectal bleeding after hypofractionated radiotherapy for localized prostate cancer: a single-center retrospective study.局部前列腺癌短程放疗后迟发性直肠出血的患者相关危险因素:单中心回顾性研究。
Radiat Oncol. 2022 Feb 9;17(1):30. doi: 10.1186/s13014-022-01998-4.
9
[Chronic radiation-induced rectal injury after adjuvant radiotherapy for pelvic malignant tumors: report based on a phase 3 randomized clinical trial].盆腔恶性肿瘤辅助放疗后慢性放射性直肠损伤:基于一项3期随机临床试验的报告
Zhonghua Wei Chang Wai Ke Za Zhi. 2021 Nov 25;24(11):962-968. doi: 10.3760/cma.j.cn441530-20210720-00292.
10
[Chinese expert consensus on multidisciplinary diagnosis and treatment of radiation rectal injury (2021 edition)].《放射性直肠损伤多学科诊疗中国专家共识(2021年版)》
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