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子宫颈癌放射治疗致放射性膀胱炎378例临床分析 被引量:16

Late Bladder Complications following Radiotherapy of Carcinoma of the Uterine Cervix
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摘要 对1958年2月至1987年10月中国医学科学院肿瘤医院宫颈癌放射治疗(放疗)后发生的放射性膀胱炎378例进行回顾性分析。结果表明,放射性膀胱炎患者占同期行放疗的宫颈癌患者的3.2%。本病发生与年龄、放疗前FIGO分期、传统腔内治疗及后装腔内放疗无明显关系,但与肿瘤局部情况有失。66.5%的病例属外生型肿瘤。多数患者(51.1%)发病于放疗后2~5年,5~10年间发病者占16.7%,有3.4%发病于放疗后1年内。本组有39.4%和31.6%病例的腔内和体外照射剂量高于常规剂量的10%。根据临床表现和膀胱镜的特点,特放射性膀胱炎分为3类:突发和暂时性血尿,占35.7%;顽固性血尿,63.2%;膀胱阴道瘘,1.1%。保守性治疗可取得一定疗效。放射性膀胱炎患者5年生存率为90.4%,高于传统腔内放疗的65.7%和后装治疗的70.39%。但仍有3.7%死于本并发症。提示:避免膀胱过量照射及注意自身的保护是减少本病发生的方法。 Objective To analyse the causes,clinical features, treatment and prevention of late bladder com-plications following radiotherapy of carcinoma of the uterine cervix.Method This clinical retrospective study included 378 cases of irradiation cystitis following radio-therapy for carcinoma of the uterine cervix from February, 1958 to October,1987.Results The incidence of irradiation cystitis was 3.2%and was not related to age,FIGO stagingand the methods of intracavitary irradiation(conventional or afterloading).It was related to the externalappearance of the local lesion; 66.5%of the tumors of patients with late bladder complications was ofthe exophytic type prior to radiotherapy, 51.1%of the patients developed late bladder complications in aperiOd of 2~5 years after radiotherapy; 1 6.7%in 5~10 years and only 3.4%within the first years.The patients with irradiation cystitis had received a 10%higher dosage than that routine delivered,asfound either in intracavitary irradiation of 39.4%of patients or in external irradiation of 31.6%of pa-tients, Based on the clinical features and cystoscopic findings,late bladder complications can be dividedinto three types:(1)sudden and temporary hematuria(35.7%);(2)persistent hematuria (63.2%);and(3)vesico-vaginal fistula(1.1%).The 5-year survival rate of patients with irradiation cystitis was90.4%which was higher than the survival rates of all patients treated by conventional intracavitary irra-diation(65.7%)and all patients treated by afterloading intracavitary irradiation(70.4%).3.7%of patients died of late bladder complications.Conclusions To decrease the occurrence of late bladder complications and to obtain long termsurvival :(1) Dosage to the bladder should be adequate,and over dose to the bladder should by allmeans be avoided;(2) Patients are to be taught to observe indicated personal care during radiotherapyas well as in the follow-up period;(3) Early institutution of proper conservative treatment of cvstitis isbeneficial.
出处 《中华妇产科杂志》 CAS CSCD 北大核心 1995年第12期741-743,共3页 Chinese Journal of Obstetrics and Gynecology
关键词 子宫颈肿瘤 放射疗法 辐射损伤 膀胱炎 Cervix neoplasms Radiotherapy Radiation injuries Cystitis
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参考文献1

  • 1孙建衡,中华肿瘤杂志,1992年,14卷,225页

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