宫颈癌患者放射性直肠炎的发生率及相关因素分析  

Analysis of the incidence and related factors of radiation proctitis in patients with cervical cancer treated with radiotherapy

作　　者：韩雨霏 修雨婷 孟凡旭[2] 王蕴龙 于鸿[3] 赵方林 孙宝胜[2] HAN Yufei;XIU Yuting;MENG Fanxu;WANG Yunlong;YU Hong;ZHAO Fanglin;SUN Baosheng(Changchun University of Traditional Chinese Medicine,Changchun 130117,China;Department of Radiotherapy,Jilin Province Cancer Hospital,Changchun 130012,China;Jilin Province Institute of Cancer Prevention and Treatment,Jilin Province Cancer Hospital,Changchun 130012,China)

机构地区：[1]长春中医药大学,吉林长春130117 [2]吉林省肿瘤医院放疗科,吉林长春130012 [3]吉林省肿瘤防治研究所,吉林长春130012

出　　处：《中国实验诊断学》2025年第2期169-175,共7页Chinese Journal of Laboratory Diagnosis

基　　金：2024年吉林省预算内基本建设资金(创新能力建设)(2024C017-6)。

摘　　要：目的探讨宫颈癌患者放疗后放射性直肠炎(Radiation proctitis,RP)的发生率与临床特征及直肠受照剂量、体积等放疗参数的关系。方法回顾性分析2021年7月至2022年12月在吉林省肿瘤医院进行诊治并接受盆腔放疗的112例宫颈癌患者放疗前的临床特征和放疗剂量体积直方图(Dose volume histogram,DVH)参数。按是否发生RP将患者分为RP组(n=63)和非RP组(n=49),比较各因素的组间差异,应用Logistic回归分析筛选RP发生的相关因素,并用受试者工作特征(ROC)曲线评估各因素预测RP的价值。结果年龄、直肠Dmax、直肠Dmean、直肠V35及肿瘤FIGO分期是宫颈癌患者RP发生的独立风险因素(P<0.05)。ROC曲线显示以上5个指标对RP的预测具有较高的效能,较优指标为直肠Dmax(AUC=0.718,P=0.000)及肿瘤FIGO分期(AUC=0.715,P=0.000)。结论在宫颈癌患者放疗时,尽量降低直肠Dmax、直肠Dmean及直肠V35的值,对降低放射性直肠炎的发生率有重要意义,尤其在年龄较大、分期较晚的患者中。Objective To investigate the relationship between the occurrence of radiation proctitis(RP)after radio-therapy in patients with cervical cancer and clinical characteristics and radiotherapy parameters such as rectal irradiation dose and volume.Methods To retrospectively analyze the clinical characteristics and dose volume histogram(DVH)parameters of 112 patients with cervical cancer who underwent pelvic radiotherapy in Jilin Cancer Hospital from July 2021 to December 2022.All patients were divided into the RP group(n=63)or non-RP group(n=49)according to the occurrence of RP,and the differences between the groups were compared.Logistic regression analysis was used to screen the related factors of RP,and the receiver operating characteristic(ROC)curve was used to evaluate the value of each factor in predicting RP.Results Age,maximum rectal exposure dose,average rectal exposure dose,rectal V35 and tumor FIGO stage were independent risk factors for the development of RP in patients with cervical cancer(P<0.05).The ROC curve showed that the the above five indicators had high efficacy predicting RP,and the better indicators were rectal Dmax(AUC=0.718,P=0.000)and tumor FIGO stage(AUC=0.715,P=0.000).Conclusion In the radio-therapy of patients with cervical cancer,it is of great significance to reduce the incidence of radiation proctitis by reducing the values of rectal Dmax,rectal Dmean and rectal V35 as much as possible,especially in older and late stage patients.

关 键 词：宫颈癌 放射治疗 放射性直肠炎 预测 危险因素 

分 类 号：R737.33[医药卫生—肿瘤]