Vaginal stenosis in patients treated with radiotherapy for carcinoma of the cervix
Vaginal stenosis in patients treated with radiotherapy for carcinoma of the cervix
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DOI：
10.1111/j.1525-1438.2006.00348.x
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发表时间：
2006-01-01
影响因子：
4.8
通讯作者：
Cakir, B
中科院分区：
文献类型：
--
作者：
Brand, AH;Bull, CA;Cakir, B
我们研究的目的是确定接受盆腔和/或阴道放疗作为治疗一部分的宫颈癌患者阴道狭窄的发生率、时间和严重程度。我们还试图确定是否存在导致狭窄发生的诱发因素。对 1990 年 1 月 1 日至 2000 年 12 月 31 日期间诊断为宫颈癌并在 Westmead 医院接受盆腔和/或阴道放射治疗的所有患者进行了回顾性图表审查。自1990年1月1日起，前瞻性地记录了所有患者的阴道狭窄数据。收集的数据包括患者人口统计、疾病阶段、治疗方法以及阴道狭窄的发生率、时间和严重程度。一百八十八名患者接受了治疗。平均年龄为 58.6 岁。 13%的患者患有IB期疾病，45%患有II期疾病，39.5%患有III期疾病，1.5%患有IV期疾病。 179 名患者返回进行随访，98% 的患者可获得有关阴道毒性的数据。 27% 的患者出现 1 级毒性（部分狭窄或缩短，但不完全闭塞），11% 的患者出现 2 级毒性（完全闭塞）。治疗完成后平均 9.6 个月、中位 7.5 个月（范围：26 天至 5.6 年）出现任何级别的狭窄。与狭窄风险增加相关的唯一预后因素是年龄大于 50 岁（比值比 2.26）。阴道狭窄是盆腔和阴道放疗的常见并发症，发生于 38% 的患者。狭窄最常发生在治疗后的第一年。 50 岁以上的患者面临的风险最大。
The aim of our study was to determine the incidence, timing, and severity of vaginal stenosis in patients with carcinoma of the cervix who had received pelvic and/or vaginal radiotherapy as part of their treatment. We also sought to determine if there were any predisposing factors for the development of stenosis. A retrospective chart review was undertaken for all the patients diagnosed with carcinoma of the cervix between January 1, 1990, and December 31, 2000 and treated with pelvic and/or vaginal radiation at Westmead Hospital. Since January 1, 1990, data regarding vaginal stenosis has been prospectively recorded on all the patients. Data collected included patient demographics, stage of disease, treatments administered, and incidence, timing, and severity of vaginal stenosis. One hundred and eighty-eight patients were treated. Mean age was 58.6 years. Thirteen percent of patients had stage IB disease, 45% had stage II disease, 39.5% had stage III disease, and 1.5% had stage IV disease. One hundred and seventy-nine patients returned for follow-up, and data regarding vaginal toxicity were available in 98%. Twenty-seven percent had grade 1 toxicity (partial stenosis or shortening but not complete occlusion), and 11% had grade 2 (complete occlusion). Stenosis of any grade was noted at a mean of 9.6 months and median of 7.5 months (range, 26 days-5.6 years) from completion of treatment. The only prognostic factor associated with increased risk of stenosis was age greater than 50 years (odds ratio 2.26). Vaginal stenosis is a common complication of pelvic and vaginal radiotherapy, occurring in 38% of patients. Stenosis occurs most often in the first year after treatment. Patients over the age of 50 are most at risk.