直肠癌术后辅助放化疗急性不良反应多因素分析  

Prognostic factors of acute adverse reaction of adjuvant radiochemotherapy after resection of rectal cancer

作　　者：孙荣刚[1] 郑安平[1] 张光彬 任润川 张耀文[1] 

机构地区：[1]安阳市肿瘤医院放疗一科,河南安阳455000

出　　处：《现代肿瘤医学》2016年第4期607-610,共4页Journal of Modern Oncology

摘　　要：目的:研究直肠癌术后辅助放化疗急性不良反应影响因素。方法:收集2007年1月至2012年12月期间收治的Ⅱ/Ⅲ期直肠癌根治术后辅助放化疗患者79例。观察同步放化疗期间出现的急性不良反应。用Sigma Plot 12.0软件进行数据处理统计分析。结果:经Logistic回归分析发现,性别是血液系统毒性(P=0.001)、消化道毒性(P=0.015)、皮肤反应(P=0.006)的影响因素。放疗方式是消化道毒性的影响因素(P=0.012)。年龄是急性皮肤反应的影响因素(P=0.012)。女性较男性血液系统毒性发生概率性高,有统计学差异(P=0.004)。常规3野放疗较三维适形或调强放疗(P=0.003)急性消化系统发生率高,有统计学差异。女性较男性(P=0.009)、年龄≥55岁较<55岁(P=0.004)急性皮肤反应严重。结论:在直肠癌术后辅助放化疗中女性急性血液系统不良反应、急性消化道反应及急性皮肤反应均较重;年龄越大皮肤反应越重,3D-CRT及IMRT所致急性消化系统不良反应均低于常规3野放疗。Objective： To study the prognostic factors of acute adverse reaction adjuvant radiochemotherapy after resection of rectal cancer. Methods： All 79 patients with,stage II / III rectal carcinoma after radical resection of with adjuvant radiochemotherapy. Results： Logistic regression analysis showed that sex was factor of blood system toxicity（ P = 0. 001）,gastrointestinal toxicity（ P = 0. 015）,skin reaction（ P = 0. 006）. Radiotherapy was factor of gastrointestinal toxicity（ P = 0. 012）. Age was factor of acute skin reaction（ P = 0. 012）. Female got higher incidence than male in hematological toxicity probability,there was significant difference（ P = 0. 004）. Conventional three fields radiotherapy compared with 3D conformal or intensity-modulated radiotherapy had a high incidence of acute digestive system（ P = 0. 003）. Female（ P = 0. 009）,aged ≥ 55（ P = 0. 004） got a high incidence of acute severe skin reaction. Conclusion： Postoperative adjuvant radiochemotherapy in rectal cancer,female got severe reaction in acute hematological toxicity,acute gastrointestinal reaction and acute skin reaction; the older the more severe skin reaction,the adverse reaction of 3D-CRT and IMRT induced by acute digestive system were lower than the conventional three field irradiation.

关 键 词：直肠癌 辅助放化疗 毒性反应 

分 类 号：R735.3[医药卫生—肿瘤]