A modified Inflammatory Bowel Disease Questionnaire and the Vaizey Incontinence questionnaire are more sensitive measures of acute gastrointestinal toxicity during pelvic radiotherapy than RTOG grading
A modified Inflammatory Bowel Disease Questionnaire and the Vaizey Incontinence questionnaire are more sensitive measures of acute gastrointestinal toxicity during pelvic radiotherapy than RTOG grading
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DOI：
10.1016/j.ijrobp.2005.10.007
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发表时间：
2006-04-01
影响因子：
7
通讯作者：
Andreyev, HJN
中科院分区：
文献类型：
--
作者：
Khalid, U;McGough, C;Andreyev, HJN
目的：盆腔放射治疗中急性胃肠道反应的简易量表比放射治疗肿瘤组(RTOG)分级更敏感，可用于临床。方法和材料：良性胃肠道疾病的问卷调查是否检测到接受放射治疗的患者的毒性？患者完成的炎症性肠病(IBDQ)和Vaizey大小便失禁问卷在基线和第5周与医生完成的RTOG分级进行前瞻性比较。结果：共有107名患者，中位年龄63岁。治疗5周后，妇科和胃肠道肿瘤患者的症状明显多于泌尿外科患者(p=0.012；p=0.014)。总体而言，94%的患者改变了排便习惯，80%的患者排便不畅，74%的患者频繁排便，65%的患者排气困难，60%的患者疼痛，44%的患者出现内翻，40%的患者日常活动受限，39%的患者急迫，37%的患者大便失禁，40%的患者需要止泻药物。RTOG评分中位数为1(0~2分)，IBDQ评分中位数为204.5分(74~224分)，Vaizey评分中位数为5(0~20分)。放疗前化疗可增加大便失禁(p=0.002)。RTOG评分在3周后稳定，IBDQ评分在4周达到峰值，Vaizey评分在整个治疗过程中恶化。结论：与RTOG评分相比，IBDQ和Vaizey问卷具有较好的信度和敏感性，能更好地了解症状的严重程度和范围。(C)2006年爱思唯尔公司。
Purpose: Simple scales with greater sensitivity than Radiation Therapy Oncology Group (RTOG) grading to detect acute gastrointestinal toxicity during pelvic radiotherapy, could be clinically useful.Methods and Materials: Do questionnaires used in benign gastrointestinal diseases detect toxicity in patients undergoing radiotherapy? The patient-completed Inflammatory Bowel Disease (IBDQ) and Vaizey Incontinence questionnaires were compared prospectively at baseline and at Week 5 to physician-completed RTOG grading.Results: A total of 107 patients, median age 63 years, were recruited. After 5 weeks of treatment, patients with gynecologic and gastrointestinal cancer were more symptomatic than urologic patients (p = 0.012; p = 0.014). Overall, 94% had altered bowel habits, 80% loose stool, 74% frequency, 65% difficult gas, 60% pain, > 48% distress, 44% tenesmus, > 40% restrictions in daily activity, 39% urgency, 37% fecal incontinence, and 40% required antidiarrheal medication. The median RTOG score was 1 (range, 0-2), median IBDQ score 204.5 (range, 74-224), and median Vaizey score 5 (range, 0-20). Chemotherapy preceding radiotherapy increased fecal incontinence (p = 0.002). RTOG scores stabilized after 3 weeks, IBDQ scores peaked at Week 4, and Vaizey scores worsened throughout treatment. IBDQ and Vaizey scores distinguished between groups with different RTOG scores.Conclusion: The IBDQ and Vaizey questionnaires are reliable and sensitive, offering greater insight into the severity and range of symptoms compared with RTOG grading. (c) 2006 Elsevier Inc.