PDF(Pubmed)
Abstract：
The treatment outcomes of patients with unresectable rectal cancer are complex, and concurrent chemoradiation therapy is the main treatment option. Radiosensitizers can enhance the effect of localized intratumoral hypoxia, contributing to local control and symptomatic relief. The present study evaluated the feasibility and safety of radiosensitization using hydrogen peroxide combined with radiation therapy (RT) in patients with unresectable rectal cancer. A total of 13 patients with rectal cancer were recruited in the present study. Radiosensitization was performed twice weekly in combination with RT. Gauze soaked in 3% hydrogen peroxide solution was inserted into the anus, ensuring firm contact with the lesion. In total, 45-65 Gy was delivered in 25-33 fractions to the whole pelvis from four directions using 10 MV X-rays 5 days per week. Acute and late adverse events were evaluated 1 and 6 months after the completion of RT. Treatment was well tolerated, with no acute grade 3 or worse events noted, and no patient developed rectal fistula, necrosis, obstruction, perforation, stenosis, ulcer or retroperitoneal hemorrhage. No notable late adverse events, beyond 6 months, were observed at the end of the analysis. All patients experienced pain relief, hemostatic effects and tumor shrinkage. Therefore, the use of a hydrogen peroxide solution-soaked gauze in the rectum may be a promising option for patients with inoperable rectal tumors. The limitations of the present study are that the patient population was small and the observation time was relatively short. This study was retrospectively registered with the University Hospital Medical Information Network Center (trial registration no. R000061902) on April 21, 2024.
摘要：
不可切除的直肠癌患者的治疗结果是复杂的，同步放化疗是主要的治疗选择。放射增敏剂可以增强局部瘤内缺氧的效果，有助于局部控制和症状缓解。本研究评估了无法切除的直肠癌患者使用过氧化氢联合放射治疗（RT）进行放射增敏的可行性和安全性。本研究共招募13例直肠癌患者。每周两次与RT组合进行放射增敏。将浸泡在3%过氧化氢溶液中的纱布插入肛门，确保与病变的牢固接触。总的来说,每周5天使用10MVX射线从四个方向以25-33个部分将45-65Gy递送至整个骨盆。在RT完成后1个月和6个月评估急性和晚期不良事件。治疗耐受性良好，没有发现急性3级或更严重的事件，没有病人出现直肠瘘,坏死,阻塞,穿孔,狭窄,溃疡或腹膜后出血。无明显的晚期不良事件,超过6个月,在分析结束时观察到。所有患者疼痛缓解，止血效果和肿瘤缩小。因此,对于无法手术的直肠肿瘤患者,在直肠中使用过氧化氢溶液浸泡的纱布可能是一个有希望的选择.本研究的局限性在于患者群体较少，观察时间相对较短。本研究在大学医院医学信息网络中心进行了回顾性注册（试验注册编号：R000061902）于2024年4月21日。
