title: Radiation enterocolitis requiring surgery in patients with gynecological malignancies.
abstract: OBJECTIVE
  To identify the characteristics, risk factors, and clinical outcomes of radiation enterocolitis requiring surgery in patients with gynecologic malignancies.
  
  
  METHODS
  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.
authors: Department of Radiology, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa 903-0215, Japan.
authors: Shiro
authors: S
authors: Iraha
authors: Kazuhiko
authors: K
authors: Ogawa
authors: Hidehiko
authors: H
authors: Moromizato
authors: Masayuki
authors: M
authors: Shiraishi
authors: Yutaka
authors: Y
authors: Nagai
authors: Hironori
authors: H
authors: Samura
authors: Takafumi
authors: T
authors: Toita
authors: Yasumasa
authors: Y
authors: Kakinohana
authors: Genki
authors: G
authors: Adachi
authors: Wakana
authors: W
authors: Tamaki
authors: Makoto
authors: M
authors: Hirakawa
authors: Kazuya
authors: K
authors: Kamiyama
authors: Morihiko
authors: M
authors: Inamine
authors: Tadashi
authors: T
authors: Nishimaki
authors: Yoichi
authors: Y
authors: Aoki
authors: Sadayuki
authors: S
authors: Murayama
mesh_terms: D000704:Analysis of Variance; D004760:Enterocolitis / Q000209:etiology / Q000601:surgery*; D005260:Female; D005833:Genital Neoplasms, Female / Q000532:radiotherapy*; D006801:Humans; D007422:Intestines / Q000528:radiation effects*; D008875:Middle Aged; D011832:Radiation Injuries / Q000601:surgery*; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors