Pellerin J P, Nguyen-Qui J L, Bollack C
J Urol (Paris). 1982;88(5):285-93.
The authors study 39 cases of late genitourinary sequelae following abdominopelvic radiotherapy. Several points appear to be of interest: - the mean latent period was 3.5 years for bladder sequelae and 4 years for ureteric complications. Fistulae could develop on average 14 years after radiotherapy; - the possibility of ureteric complications in the form of stenosis after radiotherapy, exclusive of associated surgery; - all lesions were purely due to radiation, excluding recurrences of neoplasm; - bladder complications had striking symptoms with dysuria and haematuria. Ureteric stenosis was sometimes found by chance, being latent; - associated digestive tract radiation lesions were seen in 1 case in 4; - the frequent need for surgery, since this was required in 30 patients out of 39. The operations performed were often extensive; - the grave nature of surgical operations including a digestive phase in these patients who had received large doses of radiation. Peritonitis due to the breakdown of sutures was a notable source of mortality; - one of the great difficulties in investigating such patients is to be able to confirm the purely radiation aetiology of these complications, bearing in mind that amongst urological complications following the treatment of pelvic carcinomas, the majority are related not only to radiation but also to recurrence of neoplasm.
作者研究了39例腹盆腔放疗后晚期泌尿生殖系统后遗症。有几点似乎值得关注:-膀胱后遗症的平均潜伏期为3.5年,输尿管并发症的平均潜伏期为4年。瘘管平均可在放疗后14年出现;-放疗后出现输尿管狭窄形式的并发症的可能性,不包括相关手术;-所有病变均纯粹由辐射引起,不包括肿瘤复发;-膀胱并发症有明显症状,如排尿困难和血尿。输尿管狭窄有时是偶然发现的,处于潜伏状态;-四分之一的病例出现相关消化道放射性损伤;-频繁需要手术,因为39例患者中有30例需要手术。所进行的手术往往范围广泛;-这些接受大剂量辐射的患者的手术性质严重,包括消化阶段。缝线破裂导致的腹膜炎是一个显著的死亡原因;-研究此类患者的一大困难在于能够确认这些并发症纯粹由辐射引起,要记住在盆腔癌治疗后的泌尿系统并发症中,大多数不仅与辐射有关,还与肿瘤复发有关。