Radiation Enterocolitis Requiring Surgery in Patients With Gynecological Malignancies

Journal Article · Sun Jul 15 04:00:00 UTC 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.01.040· OSTI ID:20953560

Iraha, Shiro ^[1]; Ogawa, Kazuhiko ^[1]; Moromizato, Hidehiko ^[2]; Shiraishi, Masayuki ^[3]; Nagai, Yutaka ^[2]; Samura, Hironori ^[3]; Toita, Takafumi ^[1]; Kakinohana, Yasumasa ^[1]; Adachi, Genki ^[1]; Tamaki, Wakana ^[1]; Hirakawa, Makoto ^[2]; Kamiyama, Kazuya ^[1]; Inamine, Morihiko ^[2]; Nishimaki, Tadashi ^[3]; Aoki, Yoichi ^[2]; Murayama, Sadayuki ^[1]

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1. Department of Radiology, University of the Ryukyus, Okinawa (Japan)
2. Department of Obstetrics and Gynecology, University of the Ryukyus, Okinawa (Japan)
3. Department of Surgery, University of the Ryukyus, Okinawa (Japan)

Purpose: To identify the characteristics, risk factors, and clinical outcomes of radiation enterocolitis requiring surgery in patients with gynecologic malignancies. Methods and Materials: The records of 1,349 patients treated with pelvic radiotherapy were retrospectively reviewed. The majority of the patients (88%) were treated with 50 Gy or 50.4 Gy pelvic irradiation in conventional fractionations with anteroposterior fields. Results: Forty-eight patients (3.6%) developed radiation enterocolitis requiring surgery. Terminal ileum was the most frequent site (50%) and most of the lesions had stenosis or perforation. On univariate analysis, previous abdominopelvic surgery, diabetes mellitus (DM), smoking and primary site had an impact on the complications, and on multivariate analysis, abdominopelvic surgery, DM, and smoking were independent predictors of the complications requiring surgery. After the surgical intervention, the frequency of Grade 2 or more bleeding was significantly lower in patients treated with intestinal resection in addition to decompression than those treated with intestinal decompression alone. Conclusions: Severe radiation enterocolitis requiring surgery usually occurred at the terminal ileum and was strongly correlated with previous abdominopelvic surgery, DM, and smoking. Concerning the management, liberal resection of the affected bowel appears to be the preferable therapy.

• OSTI ID: 20953560
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 68; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
DIABETES MELLITUS
ENTERITIS
PATIENTS
RADIOTHERAPY
SIDE EFFECTS
SMALL INTESTINE
SURGERY