Radiation Enterocolitis Requiring Surgery in Patients With Gynecological Malignancies
| Autor: | Hidehiko Moromizato, Yutaka Nagai, Makoto Hirakawa, Wakana Tamaki, Takafumi Toita, Sadayuki Murayama, Yasumasa Kakinohana, Hironori Samura, Yoichi Aoki, Tadashi Nishimaki, Masayuki Shiraishi, Shiro Iraha, Morihiko Inamine, Kazuhiko Ogawa, K. Kamiyama, Genki Adachi |
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| Rok vydání: | 2007 |
| Předmět: |
Cancer Research
medicine.medical_specialty Genital Neoplasms Female Decompression medicine.medical_treatment Perforation (oil well) Risk Factors Diabetes mellitus medicine Humans Radiology Nuclear Medicine and imaging Risk factor Radiation Injuries Retrospective Studies Analysis of Variance Univariate analysis Radiation Radiotherapy Enterocolitis business.industry Retrospective cohort study Middle Aged medicine.disease Surgery Intestines Radiation therapy Stenosis Oncology Female business |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 68:1088-1093 |
| ISSN: | 0360-3016 |
| Popis: | Purpose: To identify the characteristics, risk factors, and clinical outcomes of radiation enterocolitis requiring surgery in patients with gynecologic malignancies. Methods and Materials: The records of 1,349 patients treated with pelvic radiotherapy were retrospectively reviewed. The majority of the patients (88%) were treated with 50 Gy or 50.4 Gy pelvic irradiation in conventional fractionations with anteroposterior fields. Results: Forty-eight patients (3.6%) developed radiation enterocolitis requiring surgery. Terminal ileum was the most frequent site (50%) and most of the lesions had stenosis or perforation. On univariate analysis, previous abdominopelvic surgery, diabetes mellitus (DM), smoking and primary site had an impact on the complications, and on multivariate analysis, abdominopelvic surgery, DM, and smoking were independent predictors of the complications requiring surgery. After the surgical intervention, the frequency of Grade 2 or more bleeding was significantly lower in patients treated with intestinal resection in addition to decompression than those treated with intestinal decompression alone. Conclusions: Severe radiation enterocolitis requiring surgery usually occurred at the terminal ileum and was strongly correlated with previous abdominopelvic surgery, DM, and smoking. Concerning the management, liberal resection of the affected bowel appears to be the preferable therapy. |
| Databáze: | OpenAIRE |
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