Rates of Adverse IBD-Related Outcomes for Patients With IBD and Concomitant Prostate Cancer Treated With Radiation Therapy
Rates of Adverse IBD-Related Outcomes for Patients With IBD and Concomitant Prostate Cancer Treated With Radiation Therapy
复制标题
DOI：
10.1093/ibd/izz175
复制
发表时间：
2020-05-01
影响因子：
4.9
通讯作者：
Gaidos, Jill K. J.
中科院分区：
文献类型：
--
作者：
Feagins, Linda A.;Kim, Jaehyun;Gaidos, Jill K. J.
背景：炎症性肠病（IBD）患者在前列腺癌放射治疗中发生并发症的风险可能更高。然而，现有的数据是有限的，仍然存在争议的最佳治疗方法，炎症性肠病患者谁发展prostate cancer.Methods：一项回顾性队列研究，在4部退伍军人事务部医院系统。纳入了1996-2015年间诊断和治疗前列腺癌的IBD患者。我们评估了炎症性肠病的发作，炎症性肠病相关的住院治疗和炎症性肠病相关的手术在6个月，12个月和24个月的癌症诊断和生存在1年，2年和5年。炎症性肠病的耀斑是那些记录为这样的治疗医生，和治疗相应地改变。47例患者接受了外照射或近距离放射治疗，53例患者接受了非放射治疗。比较接受或不接受放射治疗的队列，在基线IBD特征、Charlson合并症指数或前列腺癌分期方面没有差异。放射治疗患者在癌症诊断后6个月内（10.6% vs 5.7%）和6-12个月（4.3% vs 1.9%）的炎症性肠病发作率高出2倍。在多元逻辑回归分析中，放射治疗（校正比值比，4.82; 95%置信区间，1.15-20.26）是复发的重要预测因子。然而，IBD相关的住院或手术率并没有显着different.Conclusions：在这项回顾性，多中心研究中，2倍的复发率被发现在前列腺癌诊断后的第一年内接受放射治疗的患者，但IBD相关的住院或手术没有差异。虽然患者应该被告知这些风险，但IBD患者的前列腺癌可能没有必要避免放射治疗。
Background: Patients with inflammatory bowel disease (IBD) may be at higher risk for complications from radiation treatment for prostate cancer. However, available data are limited, and controversy remains regarding the best treatment approach for IBD patients who develop prostate cancer.Methods: A retrospective cohort study across 4 Department of Veterans Affairs hospital systems. Patients with established IBD who were diagnosed and treated for prostate cancer between 1996-2015 were included. We assessed for flares of IBD, IBD-related hospitalizations, and IBD-related surgeries within 6, 12, and 24 months of cancer diagnosis and survival at 1, 2, and 5 years. Flares of IBD were those documented as such by the treating physician, and treatment changed accordingly.Results: One hundred patients with IBD and prostate cancer were identified. Forty-seven were treated with either treatment with external beam radiation or brachytherapy, and 53 were treated with nonradiation modalities. Comparing cohorts with or without radiation treatment, there were no differences in baseline IBD characteristics, Charlson comorbidity index, or prostate cancer stage. Inflammatory bowel disease flares were 2-fold higher for radiation-treated patients within 6 months (10.6% vs 5.7%) and 6-12 months (4.3% vs 1.9%) after cancer diagnosis. On multiple logistic regression analysis, radiation treatment (adjusted odds ratio, 4.82; 95% confidence interval, 1.15-20.26) was a significant predictor of flares. However, rates of IBD-related hospitalizations or surgeries were not significantly different.Conclusions: In this retrospective, multicenter study, 2-fold higher rates of flare were found within the first year after prostate cancer diagnosis for patients treated with radiation, but there were no differences in IBD-related hospitalizations or surgeries. Although patients should be counseled of these risks, avoidance of radiation therapy in IBD patients with prostate cancer is likely not necessary.