Libotte F, Autier P, Delmelle M, Gozy M, Pector J C, Van Houtte P, Gerard A
Service of Oncologic Surgery, Institut Jules Bordet, Brussels, Belgiumx
Acta Chir Belg. 1995;95(4 Suppl):190-4.
We reviewed the clinical and survival data of 108 consecutive patients who presented with radiation enteritis between 1965 and 1981. One hundred and two (94%) had been irradiated for carcinoma of the cervix uteri. The median follow-up was of 11 years. The median time of occurrence of severe radiation-induced lesions (obstruction, perforation) after radiotherapy was of 18 months, against 10.5 months for mild symptoms (e.g., tenesmus) and 9 months for rectal bleeding (p < 0.001). Cox survival analysis taking into account the stage of the cancer and the age at diagnosis showed that rectal bleeding is a factor with a prognosis significantly poorer than the mild symptoms (p = 0.05), equivalent to that of the severe complications. We conclude that in the evaluation of patients who underwent radiotherapy for abdominal or pelvic tumours, rectal bleeding should be considered as a sign of serious radiation-induced complication.
我们回顾了1965年至1981年间连续收治的108例放射性肠炎患者的临床和生存数据。其中102例(94%)曾因子宫颈癌接受过放疗。中位随访时间为11年。放疗后出现严重放射性损伤(梗阻、穿孔)的中位时间为18个月,轻度症状(如里急后重)为10.5个月,直肠出血为9个月(p<0.001)。考虑到癌症分期和诊断时年龄的Cox生存分析表明,直肠出血是一个预后明显比轻度症状差的因素(p = 0.05),与严重并发症相当。我们得出结论,在评估接受腹部或盆腔肿瘤放疗的患者时,直肠出血应被视为严重放射性并发症的一个迹象。