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long-term prognosis in patients with severe late radiation enteropathy:A prospective cohort study

World Journal of Gastroenterology 2007年第26期13卷 3610-3613页

作者： Annette Larsen Jon B Reitan Steinar T Aase Martin Hauer-Jensen Institute of Internal Medicine Department of OncologyHaukeland University Hospital N-5021 BergenNorway Department of Oncology The Norwegian Radium Hospital N-0310 OsloNorway Department of Pathology Haukeland University Hospital N-5021 BergenNorway Departments of Surgery and Pathology University of Arkansas for Medical SciencesCentral Arkansas Veterans Healthcare SystemLittle RockArkansasUnited States

AIM: To assess persistent symptoms and mortality in a cohort of patients with severe (grade 3-4) radiation enteropathy,59 patients were followed up after 15-18 years. METHODS: Fifty-nine patients were prospectively enrolled by twelve surgical departments. Primary malignant disease,radiation therapy and surgical management were recorded at inclusion. The cause of death or persistence of symptoms was examined in public death records or by interview of survivors. RESULTS: Thirty-nine patients had received radiation therapy for gynaecological cancers,twelve for urological cancers,four for gastrointestinal cancers and four for other malignancies. Forty-five patients (76%) required surgical intervention. Complications occurred in 11 (25%) operated patients. Forty-seven patients had died at the time of follow-up,seven (12%) died as a direct result of radiation enteropathy,while radiation enteropathy contributed to death in an additional seven patients. Four of the twelve surviving patients suffered from chronic debilitating symptoms of radiation enteropathy,while three had moderate symptoms. CONCLUSION: Patients with severe delayed radiation enteropathy have a high risk of persistence of symptoms after surgery. At least one in ten patients dies from radiation-induced bowel injury.

关键词： Radiation enteropathy long-term follow up

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