Pelvic radiotherapy can damage surrounding tissue and organs, causing chronic conditions including bowel symptoms. We systematically identified quantitative, population-based studies of patient-reported bowel symptoms following pelvic radiotherapy to synthesize evidence of symptom type, prevalence, and severity. Medline, CINAHL, EMBASE, and PsychINFO were searched from inception to September 2022. Following independent screening of titles, abstracts, and full-texts, population and study characteristics and symptom findings were extracted, and narrative synthesis was conducted. In total, 45 papers (prostate,n= 39; gynecological,n= 6) reporting 19 datasets were included. Studies were methodologically heterogeneous. Most frequently assessed was bowel function (‘score’, 26 papers, ‘bother’, 19 papers). Also assessed was urgency, diarrhea, bleeding, incontinence, abdominal pain, painful hemorrhoids, rectal wetness, constipation, mucous discharge, frequency, and gas. Prevalence ranged from 1% (bleeding) to 59% (anal bleeding for >12 months at any time since start of treatment). In total, 10 papers compared radiotherapy with non-cancer comparators and 24 with non-radiotherapy cancer patient groups. Symptom prevalence/severity was greater/worse in radiotherapy groups and symptoms more common/worse post-radiotherapy than pre-diagnosis/treatment. Symptom prevalence varied between studies and symptoms. This review confirms that many people experience chronic bowel symptoms following pelvic radiotherapy. Greater methodological consistency, and investigation of less-well-studied survivor populations, could better inform the provision of services and support.
盆腔放疗可能损伤周围组织和器官，引发包括肠道症状在内的慢性病症。我们系统识别了关于盆腔放疗后患者报告肠道症状的基于人群的定量研究，以综合症状类型、发生率和严重程度的证据。检索了从建库至2022年9月期间的Medline、CINAHL、EMBASE和PsychINFO数据库。经过对标题、摘要和全文的独立筛选后，提取人群和研究特征及症状结果，并进行叙述性综合。共纳入45篇论文（前列腺癌39篇，妇科癌症6篇），报告了19个数据集。研究方法存在异质性。最常评估的是肠道功能（"评分"26篇，"困扰度"19篇）。此外还评估了便急、腹泻、出血、失禁、腹痛、痔疮疼痛、直肠潮湿、便秘、黏液排出、排便频率和排气等症状。发生率从1%（出血）至59%（治疗开始后任意时间点持续超过12个月的肛门出血）不等。共有10篇论文将放疗组与非癌症对照组比较，24篇与非放疗癌症患者组比较。放疗组的症状发生率更高/严重程度更重，且放疗后症状比诊断/治疗前更常见/更严重。不同研究和症状间的发生率存在差异。本综述证实许多人在盆腔放疗后经历慢性肠道症状。加强方法学一致性并对研究不足的幸存者群体开展调查，可更好地为服务支持提供依据。
肿瘤(癌症)患者之家