中国放射性直肠损伤多学科诊治专家共识(2021版)  

Chinese expert consensus on multidisciplinary diagnosis and treatment of radiation rectal injury(2021 edition)

作　　者：中华医学会外科学分会结直肠外科学组 中国医师协会外科医师分会结直肠外科医师委员会 中国抗癌协会大肠癌专业委员会 兰平 马腾辉 Colorectal Surgery Group,Branch of Surgery,Chinese Medical Association;Colorectal Surgeon Committee,Surgeon Branch,Chinese Medical Doctor Association;Colorectal Cancer Professional Committee,Anti-Cancer Association of China;Lan Ping;Ma Tenghui

机构地区：[1]不详 [2]中山大学附属第六医院

出　　处：《中华胃肠外科杂志》2021年第11期937-949,共13页Chinese Journal of Gastrointestinal Surgery

摘　　要：放射治疗在盆腔恶性肿瘤患者综合治疗中发挥着重要作用,但可能导致部分患者出现直肠放射性损伤,对其躯体健康及生活质量产生影响。放射性直肠损伤患者常合并盆腔整体性损伤,其病情评估应强调多学科协作,综合临床、内镜、影像学及组织病理学等方面,运用各项客观评分标准对患者肿瘤学预后、放射性肠损伤病变严重程度及病情所处阶段进行评估并细化临床分型,以确定整体治疗策略和制定个体化治疗方案。应充分考虑疾病的自限性特点,对早期病变尽可能采用非手术治疗方法;而对病情反复、病变持续进展出现晚期严重并发症的患者,应尽快进行手术干预。在损伤预防上,针对放射性直肠损伤的高危患者,应通过放疗技术改进、物理防护及药物预防等方法进行综合预防。本共识旨在为我国放射性直肠损伤临床诊疗实践提供指导意见。Radiation therapy plays a significant role in the integrated treatment for patients with pelvic malignancies,but may lead to radiation-induced rectal injury in some patients,which may affect their physical health and quality of life negatively.Patients with radiation-induced rectal injury are often complicated with pelvic multi-organ injury.Collaborative,multidisciplinary evaluation of pelvic injuries should be highlighted in clinical practices,including clinical,endoscopic,radiological and histopathologic evaluation.To determine the overall treatment strategy and develop individualized treatment strategy,it is necessary to assess the oncologic prognosis,severity and stage of radiation-induced rectal injury and clinical classification using different rating scales.Considering that the disease is self-limiting,non-surgical treatment should be performed for patients with early lesions,while surgical interventions should be performed as soon as possible for patients with severe complications.In terms of prevention of radiation-induced rectal injury,prevention should be targeted for patients at high risk of radiation-induced rectal injury through technique improvement,physical protection and drug prevention.This consensus aims to provide guidance for the clinical practice of radiation-induced rectal injury in China.

关 键 词：放射性直肠损伤 临床分型 多学科诊治 预防 共识 

分 类 号：R730.55[医药卫生—肿瘤]