放疗前贫血对鼻咽癌患者调强放疗疗效及不良反应的影响

发布时间：2018-02-11 23:05

本文关键词： 鼻咽肿瘤放射疗法贫血预后　出处：《肿瘤》2014年06期 　论文类型：期刊论文

【摘要】：目的 :探讨放疗前贫血对鼻咽癌患者调强放疗(intensity-modulated radiation therapy,IMRT)近期疗效及不良反应的影响。方法 :148例鼻咽癌初诊患者根据放疗前血红蛋白水平分为贫血组(43例)和正常血红蛋白组(105例),局部晚期患者在放疗前先行诱导化疗2个周期(顺铂联合5-氟尿嘧啶),除Ⅰ期以外的所有患者放疗时均进行同期化疗(顺铂)。放疗结束后评价2组患者的近期疗效和不良反应。结果 :放疗结束时,贫血组鼻咽病灶完全缓解(complete response,CR)率为69.8%,部分缓解(partial response,PR)率为30.2%;正常血红蛋白组CR率为85.7%,PR率为14.3%,2组间疗效差异有统计学意义(P=0.025)。放疗结束时,贫血组颈部转移淋巴结CR率为72.1%,PR率为27.9%;正常血红蛋白组CR率为87.6%,PR率为12.4%,2组间疗效差异有统计学意义(P=0.023)。放疗后3个月,2组患者鼻咽病灶CR率均为100%。放疗后3个月,贫血组颈部转移淋巴结CR率为95.3%,PR率为2.3%;正常血红蛋白组CR率为99.0%,PR率为1.0%,2组间疗效差异无统计学意义(P=0.236)。贫血组严重(3~4级)急性黏膜反应的发生率[14.0%(6/43)]少于正常血红蛋白组[26.7%(28/105)],但差异无统计学意义(P0.05)。结论 :鼻咽癌患者放疗前血红蛋白水平对IMRT的近期疗效影响不明显。
[Abstract]:Objective: to investigate the effect of anemia before radiotherapy on the short-term efficacy and adverse reactions of intensity-modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). Methods: one hundred and forty-eight patients with nasopharyngeal carcinoma were divided into anemia group (n = 43) and positive group (n = 43) according to the level of hemoglobin before radiotherapy. In the hemoglobin group of 105 patients, two cycles of chemotherapy (cisplatin combined with 5-fluorouracil) were induced before radiotherapy. All patients except stage I received concurrent chemotherapy (cisplatin). Results: at the end of radiotherapy, In anemia group, the complete remission of nasopharyngeal lesions was 69.8%, partial response PRR was 30.2%, in normal hemoglobin group the CR rate was 85.7% and PR rate was 14.33%. There was significant difference in the curative effect between the two groups at the end of radiotherapy. The CR rate of metastatic lymph nodes in the anemic group was 72.1 and the PR rate in the normal hemoglobin group was 27.90.The CR rate in the normal hemoglobin group was 87.6 and the PR rate in the normal hemoglobin group was 12.44.There was significant difference in the curative effect between the two groups. The CR rate of nasopharynx focus was 100 in the two groups 3 months after radiotherapy. The CR rate of metastatic lymph nodes in the anemic group was 95.3and the PR rate of the normal hemoglobin group was 2.3.The CR rate of the normal hemoglobin group was 99.0and the PR rate of the normal hemoglobin group was 1.0. There was no significant difference in the curative effect between the two groups. The incidence of acute mucosal reaction in the anemia group was less than that in the normal blood red egg group [14.0% = 6 / 43]. White group [26.7R 28 / 105], but the difference was not statistically significant (P 0.05). Conclusion: hemoglobin level in nasopharyngeal carcinoma patients before radiotherapy has no significant effect on the short-term curative effect of IMRT.
【作者单位】：佛山市第一人民医院肿瘤中心头颈放疗一科;佛山市第一人民医院病案统计室;
【分类号】：R739.63

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