Correlation of smoking history and other patient characteristics with major complications of pelvic radiation therapy for cervical cancer
Correlation of smoking history and other patient characteristics with major complications of pelvic radiation therapy for cervical cancer
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DOI：
10.1200/jco.2002.10.128
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发表时间：
2002-09-01
影响因子：
45.3
通讯作者：
Thames, H
中科院分区：
文献类型：
--
作者：
Eifel, PJ;Jhingran, A;Thames, H
用途：本研究的目的是确定影响盆腔放射治疗严重晚期并发症风险的患者相关因素，患者和方法：3,489例接受放射治疗的国际妇产科联合会I期或11例宫颈癌患者的记录进行了审查，以了解患者的特点，治疗细节和结果。治疗后发生或持续超过3个月的任何并发症，需要住院、输血或手术或导致严重症状或患者死亡，均被视为重大晚期并发症。并发症发生率计算精算。随访的中位持续时间为85个月，99%的患者随访至少3年或直到他们dead.Results：重度吸烟是最强的独立预测的整体并发症（多变量风险比，2.30; 95%置信区间[CI]，1.84至2.87）。吸烟对小肠并发症的影响最显著（每天吸烟一包或多包的吸烟者的风险比为3.25; 95%CI为2.21 - 4.78）。西班牙裔的小肠并发症发生率明显低于白人，黑人的膀胱和直肠并发症发生率高于白人。瘦的妇女有胃肠道并发症的风险增加，和肥胖的妇女更有可能有严重的膀胱complications.Conclusion：盆腔放射治疗的并发症与吸烟，种族，和其他患者的特征密切相关。在将临床研究结果推广到不同的文化和种族群体之前，应考虑这些因素。(C)2002年，美国临床肿瘤学会。
Purpose: The purpose of this study was to identify patient-related factors that influence the risk of serious late complications of pelvic radiation therapy.Patients and Methods: The records of 3,489 patients treated with radiation therapy for International Federation of Gynecology and Obstetrics stage I or 11 carcinoma of the cervix were reviewed for information about patient characteristics, treatment details, and outcomes. Any complication occurring or persisting more than 3 months after treatment that required hospitalization, transfusion, or an operation or caused severe symptoms or the patient's death was considered a major late complication. Complication rates were calculated actuarially. The median duration of follow-up was 85 months, and 99% of patients were followed for at least 3 years or until they died.Results: Heavy smoking was the strongest independent predictor of overall complications (multivariate hazard ratio, 2.30; 95% confidence interval [CI], 1.84 to 2.87). The most striking influence of smoking was on the incidence of small bowel complications (hazard ratio for smokers of one or more packs per day, 3.25; 95% CI, 2.21 to 4.78). Hispanics had a significantly lower rate of small bowel complications than whites, and blacks had higher rates of bladder and rectal complications than whites. Thin women had an increased risk of gastrointestinal complications, and obese women were more likely to have serious bladder complications.Conclusion: Complications of pelvic radiation therapy are strongly correlated with smoking, race, and other patient characteristics. These factors should be considered before the results of clinical studies are generalized to different cultural and racial groups. (C) 2002 by American Society of Clinical Oncology.