子宫颈癌患者放射性直肠炎的发生率及其危险因素分析  

Analysis of the Incidence and Risk Factors of Radiation Proctitis in Patients with Cervical Cancer

作　　者：严金金[1] 刘佳[1] YAN Jinjin;LIU Jia(Jiangxi Maternal and Child Health Hospital,Nanchang 330006,China)

机构地区：[1]江西省妇幼保健院,江西南昌330006

出　　处：《中国医学创新》2021年第35期6-9,共4页Medical Innovation of China

摘　　要：目的:观察子宫颈癌患者放射性直肠炎(RP)的发生率,分析其危险因素。方法:纳入2019年1月-2020年6月本院收治的120例子宫颈癌患者,放疗后至少随访3个月,观察RP发生率,比较RP与非RP患者的临床病理资料,采用多因素logistic回归法分析RP发生的危险因素。结果:RP发生率为50.83%(61/120),其中急性RP发生率为36.67%(44/120),慢性RP发生率为14.17%(17/120);1、2、3、4级RP发生比例分别为78.69%(48/61)、13.11%(8/61)、6.56%(4/61)、1.64%(1/61)。不同年龄、直肠平均受照射剂量、直肠V30、直肠V40、直肠V50中RP发生率比较,差异均有统计学意义(P<0.05)。年龄≥60岁[OR=1.249,95%CI(1.022,1.615),P<0.05]、直肠平均受照射剂量≥40 Gy[OR=1.358,95%CI(1.097,1.704),P<0.05]、直肠V40≥40%[OR=1.375,95%CI(1.119,1.762),P<0.05]是子宫颈癌患者发生RP的独立危险因素。结论:子宫颈癌患者中RP发生率较高,特别是急性RP;高龄、直肠受照射剂量大、直肠受40 Gy剂量照射体积大是子宫颈癌患者发生RP的危险因素。Objective:To observe the incidence of radiation proctitis (RP) in patients with cervical cancer and analyze its risk factors.Method:A total of 120 patients with cervical cancer treated in our hospital from January 2019 to June 2020 were enrolled.All the patients were followed-up at least 3 months after radiotherapy.The incidence of RP was observed,the clinic and pathological data were compared between RP and non-RP patients.The multivariate logistic regression was used to analyze the risk factors of RP.Result:The incidence of RP was 50.83% (61/120),including 36.67% (44/120) of acute RP and 14.17% (17/120) of chronic RP.The proportions of grade 1,2,3 and 4 of RP were 78.69% (48/61),13.11% (8/61),6.56% (4/61) and 1.64% (1/61),respectively.There were statistically significant differences in the incidence of RP among different ages,average rectal exposure dose,rectal V30,rectal V40 and rectal V50 (P<0.05).Age ≥60 years[OR=1.249,95%CI (1.022,1.615),P<0.05],average rectal exposure dose ≥40 Gy[OR=1.358,95%CI (1.097,1.704),P<0.05],rectal V40 ≥40%[OR=1.375,95%CI (1.119,1.762),P<0.05]were the independent risk factors of RP in patients with cervical cancer.Conclusion:The incidence of RP is high in patients with cervical cancer,especially acute RP;the old age,high dose of rectal exposure and large exposure volume of 40 Gy dose in rectum are the risk factors of RP in patients with cervical cancer.

关 键 词：子宫颈癌 放射性直肠炎 放射治疗 危险因素 

分 类 号：R737.33[医药卫生—肿瘤] R818[医药卫生—临床医学]