炎性肠病（IBD）在历史上一直被认为是盆腔放疗（RT）的相对禁忌症。迄今为止，还没有系统综述总结IBD合并前列腺癌接受RT患者的毒副反应状况。对PubMed/EMBASE进行了PRISMA指导下的系统检索，寻找报道IBD患者接受RT治疗前列腺癌的胃肠道（GI；直肠/肠）毒副反应的原始调查研究。由于患者人群、随访和毒副反应报告方法之间存在重大的异质性，无法进行形式化的荟萃分析，但有关个体研究水平的数据和汇总率的总结被描述。共包括194例患者的12项回顾性研究，其中5项主要研究低剂量率（LDR）播种治疗（BT）单独疗法，1项主要研究高剂量率（HDR）BT单独疗法，3项混合外部束放疗（3D适形放疗或调强放疗）和LDR-BT，1项调强放疗和HDR-BT，以及2项立体定向放疗。在这些研究中，曾接受盆腔放疗、曾接受手术或患有活跃性IBD的患者比例较低。除一项研究外，晚期3+级GI毒副反应的发生率均＜5%。总的急性和晚期2+级GI毒副事件的发生率分别为15.3%（n=177可评估患者中的27例，最少0%，最多100%）和11.3%（n=177可评估患者中的20例，最少0%，最多38.5%）。急性和晚期3+级GI毒副事件的发生率为3.4%（6例，最少0%，最多23%）和2.3%（4例，最少0%，最多15%）。患有合并IBD的前列腺肿瘤患者进行RT似乎与低发生率的3+级GI毒副反应有关，但可能存在较高的毒副反应风险。因为某些高风险亚群的比例较低，应谨慎推广。应考虑几种策略作为最佳实践，以最小化这种易感人群毒副反应的可能性，包括仔细选择患者、最小化非必要治疗范围、使用节肠技术和采用现代RT进展技术来最大限度地减少对GI危险器官的暴露（例如IMRT、MRI导向规划、图像引导）。版权所有©2023 Elsevier Inc.发表。

Inflammatory bowel disease (IBD) has historically been considered a relative contraindication for pelvic radiotherapy (RT). To date, no systematic review has summarized the toxicity profile of RT for prostate cancer in patients with comorbid IBD.A PRISMA-guided systematic search was conducted on PubMed/EMBASE for original investigations that reported gastrointestinal (GI; rectal/bowel) toxicity in patients with IBD undergoing RT for prostate cancer. The substantial heterogeneity between patient population, follow-up, and toxicity reporting practices precluded a formal meta-analysis, however a summary of the individual study-level data and pooled rates were described.Twelve retrospective studies with 194 patients were included, 5 examined predominantly low-dose-rate (LDR) brachytherapy (BT) monotherapy, 1 predominantly high-dose-rate (HDR) brachytherapy monotherapy, 3 mixed external-beam RT (3D-conformal or intensity-modulated RT [IMRT]) and LDR-BT, 1 intensity-modulated RT and HDR-BT, and 2 stereotactic RT. Amongst these studies, patients with active IBD, patients receiving pelvic RT, and patients with prior surgery were underrepresented. In all but one publication, the rate of late grade 3+ GI toxicities was <5%. The pooled rate of acute and late grade 2+ GI events was 15.3% (n=27/177 evaluable patients, min-max 0-100%) and 11.3% (n=20/177 evaluable patients; min-max: 0-38.5%), respectively. Acute and late grade 3+ GI events was 3.4% (6 cases, min-max: 0-23%) and 2.3% (4 cases, min-max: 0-15%).Prostate RT in patients with comorbid IBD appears to be associated with low rates of grade 3+ GI toxicity; however, the possibility of a higher risk of toxicity remains. Because certain higher-risk subpopulations were underrepresented, overgeneralization is cautioned against. Several strategies should be considered best practice to minimize the probability of toxicity in this susceptible population including careful patient selection, minimizing elective treatment volumes, utilizing rectal sparing techniques, and employing contemporary RT-advancements to minimize exposure to GI organs-at-risk (e.g., IMRT, MRI-based planning, image-guidance).Copyright © 2023. Published by Elsevier Inc.