Urologic and sexual morbidity following multimodality treatment for locally advanced primary and locally recurrent rectal cancer
Urologic and sexual morbidity following multimodality treatment for locally advanced primary and locally recurrent rectal cancer
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DOI：
10.1053/ejso.2000.1099
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发表时间：
2001-04-01
期刊：
影响因子：
--
通讯作者：
Wiggers, T
中科院分区：
文献类型：
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作者：
Mannaerts, GHH;Schijven, MP;Wiggers, T
目的：在局部晚期原发性或局部复发性直肠癌患者的治疗中，肿瘤学方面受到了极大的关注。在长期生存者中，泌尿生殖系统的发病率对生活质量有很大的影响。本研究评估的功能结果后，在这些患者groups.Patients和方法：1994年至1999年8月，55例局部晚期原发性和66例局部复发性直肠癌进行了多模式治疗：即高剂量术前外照射放射治疗，其次是扩大手术和术中放疗。对121名患者的病历进行了审查。为了评估长期泌尿生殖系统疾病的发病率，所有仍然存活的患者，至少随访4个月，被要求填写一份关于他们排尿和性功能的问卷。目前居住的79例患者中有76例（96%）返回了问卷调查（中位随访时间为14个月，范围为4-60）。结果：问卷调查显示，31%的男性和58%的女性患者出现了可识别的排尿功能障碍。42%的局部晚期原发性直肠癌患者和48%的局部复发性直肠癌治疗后发生膀胱功能障碍。术前有性高潮的能力已经消失在50%的男性和50%的女性患者，并在45%的患者后，局部晚期原发性和局部复发性直肠癌treatment.Conclusion后57%：多模式治疗局部晚期原发性和复发性直肠癌的结果在可接受的泌尿生殖系统功能障碍，如果权衡不受控制的肿瘤进展的风险。半数患者长期排尿和性功能下降。术前咨询这些患者治疗相关的泌尿生殖系统疾病是很重要的。(C)2001年哈考特出版社有限公司
Aims: In the treatment of patients with locally advanced primary or locally recurrent rectal cancer much attention is given to the oncological aspects. In long-term survivors, urogenital morbidity can have a large effect on the quality of life. This study evaluates the functional outcome after multimodality treatment in these patient groups.Patients and methods: Between 1994 and August 1999, 55 patients with locally advanced primary and 66 patients with locally recurrent rectal cancer were treated with multimodality treatment: i.e. high-dose preoperative external beam radiation therapy, followed by extended surgery and intraoperative radiotherapy. The medical records of the 121 patients were reviewed. To assess long-term urogenital morbidity, all patients still alive, with a minimum followup of 4 months, were asked to fill out a questionnaire about their voiding and sexual function. Seventy-six of the 79 currently living patients (96%) returned the questionnaire (median FU 14 months, range 4-60).Results: The questionnaire revealed identifiable voiding dysfunction as a new problem in 31% of the male and 58% of the female patients. In 42% of patients after locally advanced primary and 48% after locally recurrent rectal cancer treatment bladder dysfunction occurred. The preoperative ability to have an orgasm had disappeared in 50% of the male and 50% of the female patients, and in 45% of patients after locally advanced primary and in 57% after locally recurrent rectal cancer treatment.Conclusion: Multimodality treatment for locally advanced primary and recurrent rectal cancer results in acceptable urogenital dysfunction if weighed by the risk of uncontrolled tumour progression. Long-term voiding and sexual function is decreased in half of the patients. Preoperative counselling of these patients on treatment-related urogenital morbidity is important. (C) 2001 Harcourt Publishers Ltd.