Radiation-Induced Cancers of the Colon and Rectum-Analysis of Five Cases

放射線誘發大腸直腸癌－五病例分析

楊靖國(Ching-Kuo Yang) ； 許自齊(Tzu-Chi Hsu) ； 王道遠(Tao-Yeuan Wang)

《中華民國大腸直腸外科醫學會雜誌》 19卷2期 (2008/06) Pp. 41-46

https://doi.org/10.6312/SCRSTW.2008.19(2).09622

摘要

目的　放射線治療可能會導致在骨盆腔內的結腸與直腸嚴重的傷害。對於接受骨盆腔放射線治療後會引起結腸直腸癌危險因素，有許多不同的意見。這篇研究分析認為是放射線治療後引起的結腸直腸癌。
方法　從1986年到2004年，有五個患者接受放射線治療後經過十年以上，後來發現有結腸直腸癌。
結果　在五個患者當中，有一個為男性，其餘為女性。年齡從65歲到87歲，平均年齡73.4歲。有四個患者是直腸癌，有一個是乙狀結腸癌。有三個患者接受放射線治療的原因是之前有子宮頸癌；一個患者是因為膀胱癌；一個是因為直腸癌。有一個患者後來接受了低位直腸切除手術；一個接受腹部會陰切除手術。三個患者因為次發的癌症接受哈特曼氏切除。
結論　我們對於放射線治療可能引起的大腸直腸癌是需要注意的。放射線治療可能帶來的好處，應該要再進一步的評估，是否會使受到放射線的腸道發展成癌症的危險。

關鍵字

放射線 ； 大腸直腸癌

並列摘要

Purpose. Acute radiation injury may cause serious complications to the pelvic colon and rectum especially in patients with pelvic malignancies. There are considerable differences of opinion about the risk for the development of colorectal cancer following pelvic irradiation. We present five patients whose tumors were considered to be radiation-induced.
Methods. A retrospective review of medical records was performed to identify colorectal cancer patients who had previously received radiotherapy following surgical treatment for their primary cancers.
Results. Review of medical records revealed 5 patients (one male and four female). Their age ranged from 65 to 87 years, with an average of 73.4 years. Four patients had rectal cancer and one patient had sigmoid colon cancer. All of these patients had radiation therapy at least 10 years prior to the development of colorectal cancer. Three patients had received radiation therapy for cervical cancer, one for bladder cancer, and one for rectal cancer. One patient underwent low anterior resection, one abdominoperineal resection and three Hartmann's resections of the colorectal cancers.
Conclusion. Irradiation may play a role in the development of colorectal cancer. Benefit of radiotherapy should be evaluated against the risk of development of cancer in the radiated bowel.

並列關鍵字

Radiation ； Colorectal cancer