宫颈癌放疗后复杂型放射性肠瘘的类型、手术治疗方式及疗效的探讨

目的探讨宫颈癌放疗后复杂型放射性肠瘘的类型、手术治疗方式及疗效。方法回顾性分析2013年1月—2020年1月郑州大学附属肿瘤医院收治的26例宫颈癌放疗后复杂型放射性肠瘘患者的临床资料, 探讨适宜的治疗方法。结果 26例患者中11例为直肠合并阴道瘘, 1例为乙状结肠合并膀胱瘘, 5例为直肠同时合并阴道及膀胱瘘, 7例单纯性低位直肠瘘合并周围顽固性感染, 2例宫颈癌根治术后辅助性放疗后回肠合并阴道残端瘘。所有患者均接受手术治疗, 其中9例行全盆腔或后盆腔切除术, 6例行病变直肠或乙状结肠切除、膀胱或阴道修补术, 7例行Hartmann术, 1例行病变小肠切除吻合、阴道修补术, 3例行单纯性横结肠造瘘或近端回肠造瘘术。术后患者未出现严重的并发症。所有患者的肠瘘症状均消失, 其中23例患者的会阴部疼痛明显缓解。术后1年内2例患者出现回肠相关瘘的症状, 无1例肠瘘相关的死亡。结论宫颈癌放疗后复杂型放射性肠瘘以直肠乙状结肠相关性肠瘘为主, 手术治疗的关键为切除病变的肠管及清除盆腔感染灶。     

233例胰十二指肠切除术后并发症及死亡危险因素多因素分析

目的 多因素分析胰十二指肠切除（PD）术后并发症及死亡危险因素。方法 233例行PD手术患者，平均年龄56岁；恶性病变210例，良性病变23例；胰头恶性肿瘤72例，壶腹周围恶性肿瘤138例。有重要器官系统合并症59例。根据病变部位分为胰腺组（81例）和壶腹周围组（152例）。结果 术后发生并发症63例（27．0％），早期并发症58例（24．9％），感染并发症28例（12．0％），多器官功能障碍15例（6．4％），出血并发症14例（6．0％），胰瘘12例（5．2％），再手术15例（6．4％），住院死亡16例（6．9％）。多因素分析提示，术后并发症的独立危险因素有重要脏器合并症、手术方式、主胰管直径及手术者经验。住院死亡的独立危险因素有术前血Cr水平、重要脏器合并症及手术者经验。再手术的独立危险因素有术前CA19—9水平、手术者经验、病灶直径及淋巴结转移。胰瘘的独立危险因素有Whipple术式、主胰管直径及手术者经验。结论 重要脏器合并症及手术者经验是PD术后并发症和住院死亡的独立危险因素；手术方式、主胰管直径及手术者经验是胰瘘的独立危险因素。因此，PD适应证及术式选择和技术的完善对于减少术后并发症及住院死亡至关重要。     

中药液保留灌肠治疗放射性直肠炎的疗效观察

为探讨中药液保留灌肠治疗放射性直肠炎的疗效,回顾分析宫颈癌放射治疗后并发放射性直肠炎73例患者的资料,其中40例采用中药液保留灌肠治疗（治疗组）,33例采用西药液保留灌肠治疗（对照组）,两组疗效进行对比分析。结果显示,治疗组痊愈22例,显效10例,有效5例,无效3例,总有效率92．5％（37／40）;对照组痊愈13例,显效9例,有效6例,无效5例,总有效率84．9％（28／33）;治疗组总有效率明显高于对照组,P〈0．05。结果表明,中药液保留灌肠治疗放射性直肠炎疗效肯定。     

腹腔镜下膀胱阴道瘘修补术16例临床经验

目的 探讨腹腔镜下膀胱阴道瘘（vesicovaginal fistula,VVF）手术方法的可行性并评价及其疗效。方法 回顾性分析2019年8月至2022年10月青岛大学附属医院收治的16例VVF患者的临床资料,包括病因、手术方法、围术期护理及疗效等。记录手术时间、术中出血量及住院时间,对手术方法及治疗效果进行分析总结。术后随访6～12个月,随访患者是否漏尿及生活质量改变等情况。结果 16例患者行经腹腔镜下膀胱阴道瘘修补术,成功15例（包括宫颈癌术后放疗患者3例）,未成功1例术后1个月再次行手术治疗后修补成功。手术时间（86.56±18.66） min,术中出血量（24.06±21.39） ml,住院时间（14.31±4.56） d,随访（9.50±1.55）个月,患者术后生活质量明显改善。结论 VVF手术方法的选择主要取决于医师的经验及患者的身体情况,腹腔镜下修补VVF具有创伤小、恢复快及成功率高等优点,是治疗VVF安全有效的手术方法。     

中晚期宫颈癌患者同步放化疗护理体会

目的总结同步放化疗中晚期宫颈癌患者的护理体会。方法回顾性分析采用紫杉醇联合奈达铂配合根治性放疗(同步放化疗)治疗中晚期宫颈癌患者的治疗和护理资料。结果接受同步放化疗的102例宫颈癌患者均顺利完成治疗计划,治疗过程中发生不同程度的骨髓抑制74例,消化道反应30例,放射性直肠炎9例,放射性膀胱炎8例,经对症治疗及护理症状缓解。结论针对接受同步放化疗治疗中晚期宫颈癌患者的不同情况,规范做好心理、用药等各项护理措施,对提高疗效,改善预后具有重要作用。     

蒙脱石散剂与还原型谷胱甘肽联合保留灌肠治疗宫颈癌放射性直肠炎的效果观察

目的：观察蒙脱石散剂与还原型谷胱甘肽联合保留灌肠治疗宫颈癌放射性直肠炎的疗效。方法：将86例宫颈癌放射性直肠炎患者随机分为观察组和对照组，每组43例。对照组患者采用还原型谷胱甘肽保留灌肠治疗，观察组患者采用蒙脱石散剂与还原型谷胱甘肽配联合保留灌肠治疗，观察2组患者治疗后直肠炎疾病活动指数（DAI）评分、炎症因子水平及不良反应发生情况。结果：观察组患者治疗后DAI指数、炎性因子水平及不良反应发生率均低于对照组（P <0.05）。结论：对宫颈癌放射性直肠炎患者采用蒙脱石散剂联合还原型谷胱甘肽保留灌肠治疗可有效改善患者的临床症状，降低炎症因子水平及不良反应发生率。     

黏膜保护剂保留灌肠预防宫颈癌放射性直肠炎的效果

目的探讨黏膜保护剂保留灌肠预防宫颈癌放疗所致直肠炎的效果。方法选择宫颈癌行根治性放射治疗患者98例,按入院时间先后顺序分为对照组52例和观察组46例,对照组于放疗前嘱患者排空大小便;观察组患者排空大小便后于放射治疗前1h用生理盐水50mL加思密达3g、地塞米松5mg保留灌肠,比较两组急、慢性放射性直肠炎发生率。结果观察组放射治疗4~5周,放疗结束后6个月、12个月放射性直肠炎发生率显著低于对照组(均P0.01)。结论黏膜保护剂保留灌肠可预防宫颈癌放疗所致直肠炎,可减少急、慢性直肠炎的发生率,减轻患者痛苦。     

宫腔镜在绝经后妇女子宫内膜病变中的诊治价值

目的探讨宫腔镜在绝经后子宫内膜病变中的诊治价值。方法回顾性分析2002年1月～2006年11月行官腔镜诊治的107例绝经后子宫内膜病变患者的临床资料，包括绝经后不规则阴道出血68例，B超检查子宫内膜增厚无阴道出血39例。并对手术时间、术中出血、并发症、术后病理和随访结果进行分析。结果106例顺利完成宫腔镜下检查及治疗，1例子宫穿孔，保守治愈。手术时间15～60min，（26．8±9．5）min，出血量10～60ml，（30．2±18．3）ml。术后病理结果：子宫内膜息肉69例（64．5％），黏膜下子宫肌瘤18例（16．8％），子宫内膜不典型增生12例（11．2％），子宫内膜癌2例（1．9％），正常子宫内膜6例（5．6％）。90例（84．1％）术后随访3～12个月，（6．0±3．8）月，其中8例子宫内膜息肉复发，再次宫腔镜手术治疗。结论官腔镜检查是绝经后子宫内膜病变首选的检查方法，可直视下观察子宫内膜的形态变化并取活检送病理；官腔镜治疗可以完整切除子宫内膜息肉、子宫黏膜下肌瘤等子宫内膜良性病变。     

31例混合型肝癌的临床病理特点与预后因素分析

目的探讨混合型肝癌的临床病理学特征以及影响手术治疗的预后因素。方法回顾性分析四川大学华西医院1995～2010年期间行手术切除的31例混合型肝癌患者临床资料,对其预后影响因素进行单因素和多因素分析。结果患者以男性居多（25例,80．6％）,中位年龄58岁;乙肝表面抗原阳性者23例（74．2％）,AFP≥20gg／L者13例（41．9％）,伴肝硬变者18例（58．1％）,8例（25．8％）伴淋巴结转移。术后1、3及5年生存率分别为61．3％、32．3％和12．9％,中位生存时间为22个月。单因素分析结果显示门静脉侵犯、镜下癌栓、淋巴结转移和切缘阳性是影响预后的不良因素。多因素分析结果提示淋巴结转移和切缘阳性是影响预后的独立危险因素。结论混合型肝癌预后差。R0切除可能提供给患者获得长期生存的唯一机会。     

胸内食管胃吻合口瘘再手术治疗的临床分析

目的 探讨食管癌、贲门癌术后胸内食管胃吻合口瘘再手术治疗的适应证、手术方法和临床效果。方法回顾性分析2008年1月至2011年6月于林州市人民医院行食管癌、贲门癌开胸手术后发生胸内食管胃吻合口瘘39例患者的临床资料。其中17例患者行再次开胸手术治疗（再手术组）,男14例、女3例,年龄（59．76±7．54）岁;其余22例患者行传统经皮置管胸腔引流治疗（传统引流组）,男17例、女5例,年龄（59．18±7．24）岁。比较两组患者相关临床资料。结果传统引流组治愈20例,死亡2例（9％）;再手术组治愈17例,无死亡病例。两组死亡率差异无统计学意义（9％VS．0％,P〉0．05）。再手术组患者第一次手术后住院时间[（29．76±7．92）d vs．（41．58±8．73）d,P〈0．001]、体重下降[（4．83±5．47）kVS．（10．05±6．21）蚝,P〈0．05]均优于传统引流组。结论胸内食管胃吻合口瘘后再手术治疗可选择应用于大部分诊断明确的患者,合理的手术治疗效果优于传统引流治疗。     

A novel treatment for haemorrhagic radiation proctitis using colonic irrigation and oral antibiotic administration

Aim Radiation‐induced haemorrhagic proctitis is not uncommon after radiotherapy for pelvic malignancy. Various treatments have been described. Recurrent bleeding and subsequent complications associated with treatment have been reported. Colonic irrigation has been used to treat defaecation disorders; however, it has not been used to treat radiation‐induced proctitis. Method A pilot study was undertaken of 12 patients with haemorrhagic radiation proctitis after radiotherapy. Four patients had had cervical cancer, five had uterine cancer, one had prostatic cancer, one had vesical cancer and one had vaginal cancer. Daily self‐administered colonic irrigation with tap water and a 1‐week period of oral antibiotics (ciprofloxacin and metronidazole) were prescribed. Results The median dose of radiation given was 54 (50–70) Gy. The median interval from radiation to the development of haemorrhagic proctitis was 26 (8–44) months. The median duration of symptomatic rectal haemorrhage prior to treatment was 8 (1–48) months. There was a significant improvement in rectal bleeding after treatment with colonic irrigation and oral antibiotic administration, accompanied by an improvement in bowel frequency and urgency, and diarrhoea. There were no complications. The majority of the patients (11/12) were satisfied with the treatment. The five patients who had previously undergone formalin therapy preferred the treatment regimen used in this study. Conclusion The preliminary results of colonic irrigation and oral antibiotics indicate that this treatment is safe and effective for radiation‐induced proctitis. Further study is warranted.     

Assessment of quality of life in patients treated with accelerated radiotherapy for laryngeal and hypopharyngeal carcinomas

BACKGROUND: This study was conducted to evaluate quality of life (QOL) and functional outcome in patients with carcinomas of the larynx and hypopharynx treated with accelerated radiotherapy (RT). METHODS: Between January 1991 and September 1996, 21 patients treated with accelerated concomitant boost RT schedule (69.9 Gy in 5. 5 weeks) for laryngeal (n = 10) or hypopharyngeal (n = 11) carcinomas and who remained free of disease at 1-year minimum follow-up were evaluated. The functional outcome was assessed by the subjective Performance Status Scale for Head and Neck cancer (PSSHN) and general QOL by the European Organization for Research and Treatment of Cancer Core QOL questionnaire (EORTC QLQ-C30). The median length of follow-up was 37 months (range, 13 to 75). RESULTS: The PSSHN scores were 89, 84, and 86, respectively, for eating in public, understandability of speech and normalcy of diet (100 = normal function). Significantly lower scores for understandability of speech were observed in patients with advanced and laryngeal carcinomas. Normalcy of diet was affected negatively by the severity of xerostomia. All mean functional scale scores of the EORTC QLQ-C30 module were 20% to 25% below the higher score. Most of these scale scores were significantly affected by the severity of xerostomia. CONCLUSIONS: Patients treated with concomitant boost RT for laryngeal and hypopharyngeal carcinomas appear to have similar QOL and functional outcome to those reported for patients treated with conventional or hyperfractionated RT. As expected, many QOL scales were affected by the severity of xero- stomia.     

Surgical therapy of late radiation sequelae of the gastrointestinal tract

Fifty-six operations for intestinal complications of radiation therapy were performed in 48 patients at the Second Surgical Clinic, University of Vienna between 1971 and 1985. The lesions were located in the small bowel (n = 32), the colon and rectum (n = 27) and the duodenum (n = 2). The incidence of the operations increased during the fifteen-years-period, 48.2% being performed in the last five years. 96% of the patients were females, the most frequent cause for irradiation was ovarian cancer (39.6%), followed by cervical (27%) and endometrial cancer (16.7%). 20 Patients (39.6%) had also been treated by chemotherapy. Ovarian cancer as underlying disease (56%) and chemotherapy (56%) were more frequent in small bowel lesions, than in other locations. The radiation damage presented as stenoses (n = 38), fistulas (n = 13), perforations (n = 3), one rectal ulcer and one hemorrhagic proctitis. Resection with end-to-end-anastomosis (n = 15) and bypass (n = 14) were the operations most frequently performed on the small bowel, whereas most colonic and rectal lesions were treated by colostomy alone (n = 14). The postoperative course was complicated by fistulas in 7 patients, by peritonitis in 5, by pulmonary embolism in one and duodenal ulcer perforation in another case. Six patients died postoperatively (10.7%), 5 because of peritonitis. After small bowel resection complications occurred in 4 cases, and two (13%) of the patients died. Bypass in small bowel lesions performed as well as resection: 5 complications and one death (7%) occurred. Single layer suture technique performed better than two layer anastomoses. Eighteen operations with single layer anastomoses resulted in 16.7% complications and no death.(ABSTRACT TRUNCATED AT 250 WORDS)     

Impact of radiation dose on complications among women with breast cancer who underwent breast reconstruction and post-mastectomy radiotherapy: A multi-institutional validation study

PurposeEmerging data suggest that higher radiation doses in post-mastectomy radiotherapy may be associated with an increased risk of reconstruction complications. This study aimed to validate previous findings regarding the impact of radiation dose on complications among women with breast cancer using a multi-center dataset.MethodsFifteen institutions participated, and women with breast cancer who received radiotherapy after either autologous or prosthetic breast reconstruction were included. The primary endpoint was major post-radiation therapy complications requiring re-operation for explantation, flap failure, or bleeding control.ResultsIn total, 314 patients were included. Radiotherapy was performed using both conventional fractionation and hypofractionation in various schedules. The range of the radiation therapy dose in Equivalent Dose in 2 Gy fractions (EQD2; α/β = 3.5) varied from 43.4 to 71.0 Gy (median dose: 48.6 Gy). Boost radiation therapy was administered to 49 patients. Major post-radiation therapy complications were observed in 24 (7.6%) patients. In multivariate analysis, an increasing EQD2 per Gy (odds ratio [OR]: 1.58, 95% confidence interval [CI]: 1.26–1.98; p < 0.001), current smoking status (OR: 25.48, 95% CI: 1.56–415.65; p = 0.023), and prosthetic breast reconstruction (OR: 9.28, 95% CI: 1.84–46.70; p = 0.007) were independently associated with an increased risk of major complications.ConclusionA dose-response relationship between radiation dose and the risk of complications was validated in this multi-center dataset. In this context, we hypothesize that the use of hypofractionated radiotherapy (40 Gy in 15 fractions) may improve breast reconstruction outcomes. Our multi-center prospective observational study (NCT03523078) is underway to further validate this hypothesis.     

TURP术对改善伴有LUTS症状的高龄前列腺癌患者生活质量的研究

目的 探讨经尿道前列腺电切术对伴有下泌尿道症状的高龄前列腺癌患者生活质量的影响.方法 回顾性分析2012年1月-2014年1月徐州医学院附属医院泌尿外科收治的75例经前列腺穿刺取活检病理确诊的高龄前列腺癌患者的临床资料,平均年龄(79±7)岁,其中55例伴有不同程度的下泌尿道症状,26例行经尿道前列腺电切术治疗.后均行规律内分泌治疗,观察记录患者诊治前及诊治后3、6、12个月时IPSS及QOL评分,比较患者生活质量的改变.结果 纳入治疗组的44例患者术后3、6、12个月IPSS评分分别为(6.25±2.53)分、(5.15 ±2.25)分、(5.00±2.36)分,与术前IPSS基础值(30.55±3.62)分比较,差异有统计学意义(P＜0.01),而术后3、6、12个月IPSS评分差异无统计学意义(P =0.209,0.863,0.154).治疗组术后3、6、12个月QOL评分分别为(1.35±1.14)分、(0.85±0.75)分、(0.70±0.87)分,与术前QOL基础值(4.70±0.73)分比较,差异有统计学意义(P＜0.01),而术后3、6、12个月QOL评分差异无统计学意义(P=0.078,0.023,0.593).治疗组及对照组的IPSS及QRI评分比较,治疗前无差异(F=0.105,P=0.747);治疗后差异显著,有统计学意义(P＜0.01).结论 经尿道前列腺电切是一种可以改善排尿困难,改善患者的生活质量,对于失去根治机会的前列腺癌患者不失为一种安全有效的方法.     

Radiation Pneumonitis in Breast Cancer Patients Treated with Taxanes: Does Sequential Radiation Therapy Lower the Risk?

Taxanes are now routinely used in conjunction with radiation therapy (RT) as adjuvant therapy for breast cancer. Recent publications have reported several cases of radiation pneumonitis (RP) in patients receiving RT and taxane chemotherapy, thus raising concern as to the safety of this combination. To decrease the potential risk of RP, we sequenced RT after taxane chemotherapy with a target interval of 3-4 weeks in two consecutive institutional breast protocols. Forty patients were treated on two adjuvant systemic protocols consisting of modified radical mastectomy (n = 9) or breast-conserving surgery (n = 31), followed by adjuvant doxorubicin, cyclophosphamide, and a sequential taxane (ACT), followed by RT. All patients had either node-positive or high-risk node-negative breast cancer and were treated between October 2000 and September 2002. Postmastectomy, a median dose of 5040 cGy was delivered to the chest wall. After breast-conserving surgery, a median dose of 4680 cGy was delivered to the breast plus a 1400 cGy boost to the surgical cavity. Information regarding RP was gathered retrospectively by reviewing patient records. With a median follow-up of 28 months (range 6-42 months), no cases of clinical RP were identified and no local failures had occurred. The median time interval for all patients between the completion of chemotherapy and the initiation of RT was 34 days (range 5-70 days). At the latest follow-up, 2 patients were diagnosed with metastatic disease and 38 patients were without evidence of disease. Sequencing of RT after taxane therapy with a target interval of 3-4 weeks does not appear to result in increased pulmonary toxicity and is associated with good local control.     

Lhermitte's sign among nasopharyngeal cancer patients after radiotherapy

BACKGROUND: Lhermitte's sign (LS) is a side effect of radiotherapy (RT) on the spinal cord and typically occurs shortly after the procedure has been conducted. When treating patients with cancer of the head and neck region with irradiation, it remains difficult to avoid exposing the cervical spinal cord to unintended radiation. In this study, we focused on nasopharyngeal cancer (NPC) alone and looked for various parameters that might influence the occurrence of LS associated with this disease after RT. METHODS: From 1979 through 1990, 1171 patients with NPC completed RT either with or without chemotherapy at the Lin-Kou Medical Center, Chang Gung Memorial Hospital (CGMH), Tao-Yuan, Taiwan; the RT regimens for these treated patients were very similar. The nasopharyngeal tumor was treated to 75 Gy by photon teletherapy and after-loading brachytherapy. The neck lymphatics were irradiated with photon irradiation to 46.8 Gy and then boosted with electron beams to 10 to 30 Gy, in accordance with the patient's nodal status, either unilaterally or bilaterally. Every patient was followed monthly for the first 3 months after therapy and subsequently every 2 to 3 months for the next 2 years and, finally, every 6 months thereafter. At follow-up, a neurologic checkup of each patient was performed to determine whether any injury to the spinal cord or brain stem had arisen. RESULTS: LS was observed for 121 patients (10.3%). The median development time for such signs was 3.0 months after the completion of RT (range, 0.2-72 months), and the appearance of such a sign lasted 1 to 82 weeks (median, 17 weeks). No statistically significant differences between the sexes were noted in the development of such a sign (p = .5263),or among various T classifications (p = .0757) and N classifications (p = .4412). The incidence of LS was significantly lower for those patients who had also received chemotherapy than it was for those who had not (p = .003), and it was also lower for patients older than 60 years than for those younger than 60 years (p = .0061). Of the subjects who did not undergo neck-lymphatic boosting or who had undergone only unilateral neck-lymphatic boosting, 7.2% had LS develop, whereas 11.5% of patients who had been boosted bilaterally had LS develop (p = .0285). CONCLUSIONS: The incidence of LS associated with NPC and after RT was higher in patients who underwent bilateral neck-lymphatic boosting by electron beams than for those who underwent unilateral boosting or who did not undergo boosting. A correlation between increased incidence of LS and RT dose on the cervical spinal cord was noted when the cord dose exceeded 48.9 Gy. Therefore, wherever possible, a CT simulator and a three-dimensional treatment-planning system should necessarily be used to verify the dose distribution of electron-beam RT to diminish the chance of radiation overdose on the cervical cord.     

术前放化疗加胸腹腔镜联合手术在局部中晚期食管癌中的应用体会

目的评估术前放化疗加胸腹腔镜联合手术治疗局部中晚期食管癌的可行性及近期疗效。方法2011年6月至2012年2月间浙江省台州医院共对11例局部中晚期（ⅡB-ⅢA期）食管癌患者予以术前放化疗加胸腹腔镜联合手术。术前化疗采取NP方案（长春瑞滨加顺铂）或TP方案（紫杉醇加顺铂）静脉注射;同期采用常规分割放疗,放疗剂量40Gy／20d。放化疗后4～6周施行胸腹腔镜联合经右胸、上腹、左颈三切口食管癌切除术。结果11例患者均完成预定同步放疗方案,期间9例出现不同程度的骨髓抑制。放化疗结束至手术的时间为（49．6±15．4）d。术中除1例患者（放化疗后75d手术）局部纤维化形成外,其余10例患者手术难度并未增加：与同期15例行单纯腔镜食管切除术的患者相比,手术时间明显缩短[（242．3±27．0）min比（280．5±27．2）min,P=0．002],术中出血量明显减少[（168．2±95．6）ml比（244．5±84．8）ml,P=0．042],淋巴结清扫数量相当[（19．5±5．8）枚／例比（20．5±7．1）枚／例,P=0．683],但术后住院时间延长[（18．9±10．3）d比（12．5±4．6）d,P=-0．020]。术后病理示,4例瘤体明显缩小,7例达到病理完全缓解。术后并发症发生率36．4％（4／11）,其中颈部吻合口瘘并肺部感染1例、颈部吻合口瘘并声嘶1例、肺部感染并胸腔积液2例。术后随访1～9个月,未见肿瘤复发。结论术前放化疗加胸腹腔镜联合手术治疗局部中晚期食管癌安全、可行．近期疗效确切。     

Personality, treatment choice and satisfaction in patients with localized prostate cancer

OBJECTIVES: Radical prostatectomy (RP), external beam radiation (XRT) and brachytherapy (BTX) are the most commonly used treatments for localized prostate cancer. We studied whether patient personality influences treatment choice and overall treatment satisfaction. METHODS: From 1998 to 2002, 219 consecutive patients treated with RP (n = 74), XRT (n = 73), or BTX (n = 72) at our institution who remained free of biochemical recurrence were sent the Big Five Inventory (BFI) and a satisfaction/treatment participation questionnaire. We compared personality, satisfaction and participation scores between the three groups. Correlation between personality and satisfaction was determined. Multivariate regression was used to determine association between personality and satisfaction/participation after controlling for patient- and disease-related factors. RESULTS: Higher mean satisfaction and participation scores were observed within the RP and XRT groups, respectively (P = NS). No significant differences in personality were observed between groups. XRT patients tended to have higher extroversion, openness and agreeability scores, while RP patients tended to be more neurotic and conscientious (all P = NS). After controlling for other factors, a negative correlation was found between openness scores and satisfaction and a positive correlation between conscientiousness scores and satisfaction. Specific personality traits were associated with interest in participation in care for both RP and BTX patients but not for XRT patients. CONCLUSIONS: There are mild variations in personality as measured by the BFI between patients undergoing treatment for localized prostate cancer. Certain BFI-measured personality traits may be associated with levels of satisfaction following therapy. Disease concerns and provider recommendations may override the influence of personality in the decision-making process.     

直肠癌术后急性放射性肠炎应用肠内营养的疗效观察

目的探讨肠内营养（EN）在直肠癌术后急性放射性肠炎中的临床治疗效果。方法将102例急性放射性肠炎的患者随机分为EN组50例及对照组52例，EN组病例均于入院当天起每天供给患者能全力2000～2500ml。对照组选择进食不含脂肪的流质（清水和米汤）、含有低脂肪的流质（鲜奶和肉汤）或半流质饮食。观察临床效果，并且测定营养支持前后患者的血糖、肝肾功能和电解质以及营养指标。结果①EN组饮食恢复时间明显短于对照组（P〈0．01）；②EN组血糖、肝肾功能、电解质和对照组没有差别；③EN组患者的精神状态及体力明显强于对照组；④EN组治疗后体重、前白蛋白和白蛋白均高于对照组（P〈0．05），视黄醇结合蛋白显著高于对照组（P〈0．01），CC反应蛋白显著低于对照组（P〈0．01）。结论EN在直肠癌术后急性放射性肠炎患者中的应用是安全并且实用有效的。