解放军医学院学报2023，Vol.44Issue(12)：1364-1371,8.DOI:10.12435/j.issn.2095-5227.2023.115
盆腔放疗发生放射性直肠损伤的影响因素分析
Influencing factors of radiation induced rectal injury in pelvic radiotherapy
摘要
Abstract
Background Pelvic and peritoneal radiotherapy is one of the indispensable methods in the treatment of malignant tumors,while radiation bowel injury caused by radiotherapy is a common clinical complication.Objective To study the factors influencing radiation-induced rectal injury in gynecologic tumor patients after radiotherapy.Methods A retrospective analysis of radiation-induced rectal injury in 324 patients who received radiotherapy for gynecological tumors in the First Medical Center of Chinese PLA General Hospital from January 2012 to January 2022 was conducted,and the correlation between related factors and radiation-induced rectal injury was analyzed.Results The total radiotherapy dose administered was substantial,resulting in an elevated likelihood of radiation-induced injury to the rectum(OR=1.038,95％CI:1.015-1.062,P<0.001).High blood pressure(OR=0.384,95％CI:0.163-0.906,P=0.029)and chemotherapy prior to radiotherapy(OR=0.433,95％CI:0.237-0.790,P=0.006)had a low likelihood of causing radiation-induced injury to the rectum.The high total dose of radiotherapy(OR=1.041,95％CI:1.020-1.062,P<0.001)and synchronous brachytherapy(OR=3.768,95％CI:1.974-7.162,P<0.001)had a high likelihood of causing acute radiation-induced rectal injury.The incidence of acute radiation-induced rectal injury decreased when surgery was conducted prior to radiotherapy.(OR=0.522,95％CI:0.282-0.968,P<0.001).The occurrence of chronic radiation-induced rectal injury was minimal when chemotherapy was administered prior to radiotherapy(OR=0.459,95％CI:0.265-0.794,P=0.005).Obese patients had a high likelihood of chronic radiation-induced rectal injury(OR=2.405,95％CI:1.081-5.347,P=0.031).Conclusion Patients who receive a high total dose of radiotherapy and concurrent brachytherapy are at a high risk for acute radiation-induced rectal injury.Conversely,patients who undergo surgery prior to radiotherapy and chemotherapy before radiotherapy have a lower probability of experiencing acute and chronic radiation-induced rectal injury.Additionally,obese patients have an elevated likelihood of developing chronic radiation-induced rectal injury.关键词
盆腔放疗/放射性直肠损伤/高危因素/妇科肿瘤/放疗并发症Key words
pelvic radiotherapy/radiation-induced rectal injury/high risk factors/gynecological tumor/radiotherapy complication分类
医药卫生引用本文复制引用
王琳,潘飞,杨微,王倩倩,李燕,曲宝林,彭丽华..盆腔放疗发生放射性直肠损伤的影响因素分析[J].解放军医学院学报,2023,44(12):1364-1371,8.基金项目
后勤科研重大项目(ALB23J008) （ALB23J008）
