High incidence of severe urologic complications following radiotherapy for cervical cancer in Japanese women
High incidence of severe urologic complications following radiotherapy for cervical cancer in Japanese women
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DOI：
10.1006/gyno.2000.6030
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发表时间：
2001-01-01
影响因子：
4.7
通讯作者：
Takeuchi, H
中科院分区：
文献类型：
--
作者：
Fujikawa, K;Miyamoto, T;Takeuchi, H
背景宫颈癌放射治疗取得了良好的效果，但许多患者遭受放射引起的邻近器官并发症。一些作者报告说，约10%接受放射治疗的患者会出现放射性并发症。我们以前曾报道，自发性膀胱破裂的发生率在日本很高，但在美国和欧洲极低。在这项研究中，我们研究了日本与美国和欧洲之间放射性并发症的发生率或类型是否不同。进行了一项回顾性研究，以确定日本妇女宫颈癌放疗后需要手术干预的严重并发症的发生率。从1981年12月至1989年3月，在科比市综合医院共治疗了271例患者，在232例患者中，外照射治疗与高剂量率腔内近距离放射治疗结合使用遥控后装系统（RALS）。在排除74例有疾病复发或进展证据的患者后，确定尿路、直肠和肠道放射诱导并发症的发生率和类型。共有16名患者（8.1%）在照射后出现需要手术干预的泌尿系统并发症，而共有26名患者（13.2%）在照射后出现需要手术干预的直肠或肠道并发症。泌尿系并发症的发生明显晚于直肠和肠道并发症（分别为6.4年和2.2年）（P < 0.0001）。严重并发症的总体发生率相对高于美国和欧洲的报告。自发性膀胱破裂的发生率在日本特别高（2.0%）。日本放疗后严重并发症的发生率相对高于美国和欧洲。特别是，自发性膀胱破裂在日本很常见。这可能是由于使用高剂量率近距离放射治疗，因为近距离放射治疗目前正在用于前列腺癌，泌尿科医生和放射科医生必须考虑这种严重并发症的高发病率的可能性，特别是当使用高剂量率近距离放射治疗。(C)北京：科学出版社.
Background. Good results have been obtained with radiation therapy for cervical cancer, but many patients suffer radiation-induced complications of adjacent organs. Some authors have reported that about 10% of patients treated with radiotherapy experience radiation-induced complications. We have previously reported that the incidence of spontaneous rupture of the urinary bladder is high in Japan but extremely low in the United States and Europe. In this study, we examined whether incidence or type of radiation-induced complications differs between Japan and the United States and Europe,Methods. A retrospective study was performed to determine the incidence among Japanese women of severe complications requiring surgical intervention following radiotherapy for cervical cancer, A total of 271 patients were treated at Kobe City General Hospital using external-beam therapy from December 1981 to March 1989, In 232 external-beam therapy was combined with high-dose-rate intracavitary brachytherapy with a remotely controlled afterloading system (RALS). The incidence and type of radiation-induced complications of the urinary tract, rectum, and intestine were determined following exclusion of 74 patients with evidence of disease recurrence or progression.Results. A total of 16 patients (8.1%) had urologic complications that required surgical intervention following irradiation, while a total of 26 patients (13.2%) had complications of the rectum or intestine that required surgical intervention following irradiation. Urologic complications occurred significantly later than those of the rectum and intestine (6.4 and 2.2 years, respectively) (P < 0.0001). The overall incidence of severe complications was comparatively higher than reported in the United States and Europe. The incidence of spontaneous rupture of the urinary bladder was particularly high (2.0%) in Japan.Conclusions. The incidence of severe complications following radiotherapy is comparatively higher in Japan than in the United States and Europe. In particular, spontaneous rupture of the urinary bladder is common in Japan. This might be due to the use of high-dose-rate brachytherapy, Since brachytherapy is currently being used for prostate cancer, urologists and radiologists must consider the possibility of a high incidence of such severe complications, especially when using high-dose-rate brachytherapy. (C) 2001 Academic Press.