TIME-COURSE AND INCIDENCE OF LATE COMPLICATIONS IN PATIENTS TREATED WITH RADIATION-THERAPY FOR FIGO STAGE IB CARCINOMA OF THE UTERINE CERVIX
TIME-COURSE AND INCIDENCE OF LATE COMPLICATIONS IN PATIENTS TREATED WITH RADIATION-THERAPY FOR FIGO STAGE IB CARCINOMA OF THE UTERINE CERVIX
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DOI：
10.1016/0360-3016(95)00118-i
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发表时间：
1995-07-30
影响因子：
7
通讯作者：
OSWALD, MJ
中科院分区：
文献类型：
--
作者：
EIFEL, PJ;LEVENBACK, C;OSWALD, MJ
目的：确定FIGO IB期子宫颈癌放疗患者放疗晚期并发症的时间进程和发生率，并评估与治疗并发症概率增加相关的患者和肿瘤因素。方法和材料：1960年至1989年期间接受初始放射治疗的1784例FIGO IB期宫颈癌患者的医疗记录如下：回顾性审查。通过门诊访视和与患者及其医生的通信获得随访。对治疗并发症进行回顾性分级。并发症发生率通过精算计算;在死亡时对死于疾病或并发疾病但未发生重大并发症的患者进行删失。有1241，924，548，和274例患者超过5，10，15，和20 yeats，分别为：IB期宫颈癌治疗的患者中，7.7%和9.3%经历了重大（大于或等于3级）并发症，在3年和5年，分别。5年后，每年约有0.34%的小但持续的风险，导致总体精算风险：20年时有14.4%的重大并发症。在随访的前3年，发生严重尿路并发症的风险约为每年0.7%，至少25年降至每年约0.25%。相比之下，在最初的2年里，直肠并发症的风险每年约为1%，随后在叶芝2至25年间急剧下降至每年约0.06%。在234例接受辅助筋膜外子宫切除术的患者中（20年时53 vs. 2.6%; p = 0.04）和111例接受预处理剖腹手术的患者中（5.2 vs. 2.9%;p = 0.007），瘘形成的风险大约增加了一倍。术前行开腹手术的患者发生小肠梗阻的风险增加（10年时14.5% vs.3.7%; p < 0.0001），
Purpose: To determine the time course and incidence of late complications from radiation therapy in patients treated with radiation for FIGO Stage IB carcinoma of the uterine cenix, and to evaluate patient and tumor factors associated with an increased probability of treatment complications.Methods and Materials: The medical records of 1784 patients with FIGO Stage IB cervical carcinoma who were treated with initial radiation therapy between 1960 and 1989 were retrospectively reviewed. Follow-up was obtained from clinic visits and correspondence with patients and their physicians. Treatment complications were graded retrospectively. Complication rates were calculated actuarially; patients who died of disease or intercurrent illness without experiencing a major complication were censored at the time of death. There were 1241, 924, 548, and 274 patients followed for more than 5, 10, 15, and 20 yeats, respectively.Results: Of patients treated for Stage IB cervical carcinoma, 7.7% and 9.3% had experienced major (greater than or equal to Grade 3) complications at 3 and 5 years, respectively. After 5 years, there was a small but continuous risk of approximately 0.34% per year, resulting in an overall actuarial risk of:having had major complications of 14.4% at 20 years. The risk of developing major urinary tract complications was approximately 0.7% per year for the first 3 years of follow-up, decreasing to about 0.25% per year for at least 25 years. In contrast, the risk of developing rectal complications was about 1% per year during the first 2 years, with a subsequent sharp decline to about 0.06% per year between Yeats 2 and 25. The risk of fistula formation was approximately doubled in the 234 patients who underwent adjuvant extrafascial hysterectomy (53 vs. 2.6% at 20 years; p = 0.04) and in the 111 patients who had pretreatment laparotomy (5.2 vs. 2.9%;p = 0.007). The risk of developing small bowel obstruction was increased in patients who underwent pretreatment laparotomy (14.5 vs. 3.7% at 10 years; p < 0.0001) and in patients who weighed