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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Is there more than one late radiation proctitis syndrome?
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Is there more than one late radiation proctitis syndrome?

机译：是否存在不止一种晚期放射性直肠炎综合征？

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PURPOSE: To investigate the significance of the various late rectal symptoms that appear after radical prostatic irradiation. PATIENTS AND METHODS: Patients with localised prostate cancer treated between 1987 and 1994 at the Mater Hospital, Newcastle with radical megavoltage irradiation were recalled for examination and to complete a detailed questionnaire concerning late radiation-induced symptoms and their effects on normal daily life. The influence of patient age treatment related variables and acute proctitis symptoms occurring during therapy or the late symptoms recorded were assessed and the relationship between late symptoms and late EORTC/RTOG score and impact on normal daily life were studied. RESULTS: The presence of symptoms of acute proctitis was the only factor to predict any of three late symptoms (urgency, frequency and diarrhoea) and late EORTC/RTOG score in this series (odds ratios: 1.7-2.57, P-values: 0.009-0.0007). Cluster and discriminant function analyses revealed the presence of five subgroups of patients with varying permutations of different late rectal symptoms, including one group with minimal symptoms (P < 0.0001). While bleeding and rectal discharge were the major contributors to late EORTC/RTOG score (P < 0.0001 and 0.04), faecal urgency and bleeding were the most important factors to impact on normal daily life (P < 0.0001 and P < 0.0003). A relatively low concordance was found between late EORTC/RTOG score and the patients' self assessment on the effect of their symptoms on their normal daily lives. Some late symptoms, including bleeding and rectal discharge become less prevalent after 3 years of follow-up with a resulting improvement in EORTC/RTOG score. CONCLUSIONS: There may be more than one late (chronic) proctitis syndrome which may be linked in greater or lesser degrees to acute proctitis symptoms occurring during therapy. Urgency is a common late symptom which often has an important impact on normal daily life and deserves recognition in late normal tissue scoring systems. Assessment of the incidence of bleeding as a measure of late rectal morbidity following prostate irradiation may underestimate the impact of these chronic effects. Confirmatory studies are necessary.
机译：目的：探讨根治性前列腺照射后出现的各种晚期直肠症状的重要性。病人和方法：召回1987年至1994年间在纽卡斯尔的Mater医院接受根治性兆伏电压放射治疗的局限性前列腺癌患者进行检查，并完成一份详细的调查表，以了解晚期放射诱发的症状及其对正常日常生活的影响。评估患者年龄相关变量和治疗期间发生的急性直肠炎症状或记录的晚期症状的影响，并研究晚期症状与晚期EORTC / RTOG得分之间的关​​系以及对正常日常生活的影响。结果：急性直肠炎症状的存在是预测该系列三个晚期症状（尿急，尿频和腹泻）和晚期EORTC / RTOG得分中的任何一个的唯一因素（奇数比：1.7-2.57，P值：0.009- 0.0007）。聚类和判别功能分析显示存在五个亚组的患者，这些患者具有不同的直肠晚期症状的变化排列，包括一组症状最小的患者（P <0.0001）。出血和直肠分泌物是晚期EORTC / RTOG评分的主要因素（P <0.0001和0.04），而粪便的紧迫性和出血是影响正常日常生活的最重要因素（P <0.0001和P <0.0003）。在晚期EORTC / RTOG评分与患者对症状对正常日常生活的影响的自我评估之间发现相对较低的一致性。随访3年后，一些晚期症状（包括出血和直肠分泌物）变得不那么普遍，从而导致EORTC / RTOG评分得到改善。结论：可能存在不止一种晚期（慢性）直肠炎综合症，或多或少地与治疗期间出现的急性直肠炎症状相关。紧急是常见的晚期症状，通常会对正常的日常生活产生重要影响，并且在晚期的正常组织评分系统中值得认可。评估前列腺癌照射后出血的发生率（以直肠直肠癌后期发病率作为衡量标准）可能会低估这些慢性影响的影响。验证性研究是必要的。

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