[Occurrence of radiation-induced injury in vagina after radical radiotherapy of cervical cancer and its affecting factors].

医学 宫颈癌 入射(几何) 阴道 放射治疗 妇产科学 外科 妇科 癌症 产科 怀孕 内科学 物理 生物 光学 遗传学
作者
K S Zhang,Z Liu,T Wang,J Wang,Jin Su,Fan Shi,R H Wang,Weijie Yuan,Y Li
出处
期刊:PubMed 卷期号:53 (4): 257-262 被引量:5
标识
DOI:10.3760/cma.j.issn.0529-567x.2018.04.009
摘要

Objective: To investigate the occurrence and degree of radiation-induced injury in vagina after radical radiotherapy of cervical cancer. Methods: A total of 282 cases of patients with cervical cancer were collected from November 2016 to September 2017. All of the above patients underwent radical radiotherapy from 2008 to 2017 in the First Affiliated Hospital of Xi'an Jiaotong University. The patients' International Federation of Gynecology and Obstetrics (FIGO) staging (2009) , brachytherapy dose, whether receive synchronous chemotherapy or not, age and body mass index (BMI) for the occurrence and severity of vaginal radiation injury at different time periods were analyzed by cross-sectional survey method. The single factor would be analyzed by the method of Chi-square test and the multiple factors would be analyzed by logistic regression method to checkout. Results: Of the 282 patients, the incidence of radiation-injury in vaginal was 84.4% (238/282) , with the incidence rate of degree Ⅰ,Ⅱ and Ⅲ radiation injury were respectively 50.7% (143/282), 29.8% (84/282) and 3.9% (11/282; χ(2)=153.375, P<0.05) , and there was no degree Ⅳ. Until the end of the follow-up time, the incidence of radiation-induced injury in vaginal after completing the treatment within 1 year, 1-2 years,>2-<5 years and ≥5 years were respectively 80.0% (24/30) , 87.2% (102/117) , 88.2% (60/68) and 77.6% (52/67; χ(2)=4.231, P=0.238) . There were 30 cases be followed within 1 year after treatment, the incidence rate of degreeⅠ,Ⅱ and Ⅲ of radiation injury in vagina was 60.0% (18/30) , 20.0% (6/30) and 0, respectively (χ(2)=28.636, P<0.05). There were 117 cases be followed between 1-2 years after treatment, the incidence rate of degreeⅠ,Ⅱ and Ⅲ vaginal radiation-induced injury were 54.7% (64/117) , 29.9% (35/117) and 2.6% (3/117) , respectively (χ(2)=77.198, P<0.05) . There were 68 cases be followed between >2-<5 years after treatment, the incidence rate of degree Ⅰ,Ⅱ and Ⅲ vaginal radiation-induced injury were 51.5% (35/68) ,33.8% (23/68) and 2.9% (2/68) , respectively (χ(2)=39.525, P<0.05) . There were 67 cases be followed ≥5 years after treatment, the incidence rate of degree Ⅰ,Ⅱ and Ⅲ vaginal radiation injury were 38.8% (26/67) , 29.9% (20/67) and 9.0% (6/67) , respectively (χ(2)=16.395, P<0.05) . The single-factor analysis result indicated that the brachytherapy dose had an obvious effect on vaginal radiation-induced injury (χ(2)=5.344, P=0.021) ; however, other factors, such as age, BMI, FIGO stages and synchronous chemotherapy, had no obvious effect on vaginal radiation-induced injury (all P>0.05) . The multifactor analysis indicated that the brachytherapy dose was an independent factor affecting the occurrence of vaginal radiation-induced injury (P=0.043) . Conclusion: After the radical radiotherapy of cervical cancer, the vaginal radiation-induced injury is associated with the dose of brachytherapy.目的: 探讨子宫颈癌根治性放疗后阴道放射性损伤的发生情况,并分析其影响因素。 方法: 采用横断面调查方法收集2008年1月至2017年4月在西安交通大学第一附属医院接受根治性放疗(即体外放疗联合腔内后装放疗),并于2016年11月至2017年9月在本院门诊复查,且具有完整临床病理资料的子宫颈癌患者共282例,其年龄为(56±9)岁(28~78岁),随访治疗结束后不同时间(包括<1年、1~2年、>2~<5年、≥5年)子宫颈癌患者阴道放射性损伤的发生率及损伤程度;并分析患者年龄、体质指数(BMI)、临床分期[按国际妇产科联盟(FIGO)2009年的临床分期标准]、后装放疗剂量、是否同步化疗对阴道放射性损伤发生的影响,单因素分析采用χ(2)检验,多因素分析采用logistic回归法。 结果: 282例子宫颈癌患者中,238例患者出现阴道放射性损伤,总发生率为84.4%(238/282);其中,Ⅰ、Ⅱ和Ⅲ度阴道放射性损伤的发生率分别为50.7%(143/282)、29.8%(84/282)和3.9%(11/282),3者比较,差异有统计学意义(χ(2)=153.375,P<0.05),无Ⅳ度阴道放射性损伤发生。至随访截止时间,随访时间<1年、1~2年、>2~<5年、≥5年的子宫颈癌患者阴道放射性损伤的发生率分别为80.0%(24/30)、87.2%(102/117)、88.2%(60/68)和77.6%(52/67),不同随访时间患者阴道放射性损伤的发生率比较,差异无统计学意义(χ(2)=4.231,P=0.238)。随访时间<1年的患者有30例,其Ⅰ、Ⅱ、Ⅲ度阴道放射性损伤的发生率分别为60.0%(18/30)、20.0%(6/30)、0,3者比较,差异有统计学意义(χ(2)=28.636,P<0.05);随访时间为1~2年的患者有117例,其Ⅰ、Ⅱ、Ⅲ度阴道放射性损伤的发生率分别为54.7%(64/117)、29.9%(35/117)、2.6%(3/117),3者比较,差异有统计学意义(χ(2)=77.198,P<0.05);随访时间为>2~<5年的患者有68例,其Ⅰ、Ⅱ、Ⅲ度阴道放射性损伤的发生率分别为51.5%(35/68)、33.8%(23/68)、2.9%(2/68),3者比较,差异有统计学意义(χ(2)=39.525,P<0.05);随访时间≥5年的患者有67例,其Ⅰ、Ⅱ、Ⅲ度阴道放射性损伤的发生率分别为38.8%(26/67)、29.9%(20/67)、9.0%(6/67),3者比较,差异有统计学意义(χ(2)=16.395,P<0.05)。单因素分析显示,后装放疗剂量对阴道放射性损伤的发生有明显影响(χ(2)=5.344,P=0.021);而患者年龄、BMI、临床分期、是否同步化疗对阴道放射性损伤的发生均无明显影响(P均>0.05)。多因素分析显示,后装放疗剂量为影响阴道放射性损伤发生的独立危险因素(P=0.043)。 结论: 子宫颈癌根治性放疗后引起的阴道放射性损伤可能与后装放疗剂量明显相关。.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
恋雅颖月应助幸福大白采纳,获得10
1秒前
4秒前
Hollow发布了新的文献求助10
4秒前
6秒前
常琳琳发布了新的文献求助10
6秒前
6秒前
LL完成签到,获得积分10
6秒前
深情安青应助slx采纳,获得10
6秒前
7秒前
7秒前
如意枫叶发布了新的文献求助10
7秒前
FashionBoy应助03采纳,获得10
9秒前
9秒前
幸福大白发布了新的文献求助30
9秒前
充电宝应助展希希采纳,获得10
11秒前
诚心谷南发布了新的文献求助10
12秒前
舒服的元瑶完成签到 ,获得积分10
12秒前
MEDwhy发布了新的文献求助10
13秒前
13秒前
14秒前
14秒前
雨天完成签到,获得积分10
14秒前
思源应助一支布洛芬采纳,获得10
15秒前
15秒前
璀璨完成签到,获得积分10
19秒前
JamesPei应助虚幻秋白采纳,获得10
19秒前
YJ888发布了新的文献求助10
20秒前
思源应助Hollow采纳,获得10
21秒前
21秒前
21秒前
盐植物完成签到,获得积分10
21秒前
22秒前
evans完成签到,获得积分10
23秒前
sanwan完成签到,获得积分10
24秒前
李健的小迷弟应助橙子采纳,获得10
26秒前
26秒前
27秒前
27秒前
孟德尔的豌豆完成签到,获得积分20
28秒前
yw11发布了新的文献求助10
28秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989550
求助须知:如何正确求助?哪些是违规求助? 3531774
关于积分的说明 11254747
捐赠科研通 3270278
什么是DOI,文献DOI怎么找? 1804966
邀请新用户注册赠送积分活动 882125
科研通“疑难数据库(出版商)”最低求助积分说明 809176