摘要
目的探讨食管癌单纯放疗及同期放化疗患者急性不良反应影响指标.方法选取食管癌患者238例,其中,单纯放疗108例,同期放化疗130例.依据美国放射肿瘤协作组(RTOG)制定的急性放射损伤分级标准进行急性不良反应评价,分析治疗期间不同营养状况评价指标(BMI、人血白蛋白、总淋巴细胞计数、血红蛋白)、炎症指标(NLR,PLR)对急性不良反应的影响.结果 238例患者治疗期间发生急性放射性肺炎60例,急性放射性食管炎173例,急性血液系统不良反应178例.总淋巴细胞计数正常组和轻度低下组Ⅱ级急性放射性肺炎发生率明显高于中度低下组和重度低下组,差异具有统计学意义(P<0. 05).人血白蛋白偏低组≥Ⅱ级急性放射性食管炎发生率明显高于正常组;高PLR组≥Ⅱ级急性放射性食管炎发生率明显高于低PLR组;差异具有统计学意义(P<0. 05).总淋巴细胞计数正常组和轻度低下组≥Ⅱ级急性血液系统不良反应发生率明显低于中度低下组和重度低下组,差异具有统计学意义(P<0. 05).多因素回归分析显示:人血白蛋白、PLR与急性放射性食管炎明显相关,总淋巴细胞计数与急性血液系统不良反应明显相关.结论行单纯放疗及同期放化疗患者中人血白蛋白、PLR为急性放射性食管炎的影响因素,总淋巴细胞计数为急性血液系统不良反应的影响因素,在放化疗中应加以重视.
Objective To investigate the impact of radiotherapy alone and concurrent chemoradiotherapy on acute adverse effects of esophageal cancer.Method 238 cases of esophageal cancers were selected,108 cases were treated by radiotherapy alone and 130 cases were treated with concurrent chemotherapy and radiotherapy.The acute adverse reaction was evaluated according to the classification standard of acute radiation injury established by the cooperative group of the American Society for Radiological Oncology.The evaluation indexes of different nutritional status before and after radiotherapy(BMI,serum albumin,total drenching cell count,hemoglobin),and inflammation were analyzed.The effect of indicators(NLR,PLR)on acute adverse reactions was analyzed.Results Among of 238 patients,there were 60 cases of acute radiation pneumonitis,173 cases of acute radiation esophagitis,and 178 cases of acute hematological adverse reactions.The incidence of acute radionuclide pneumonia in the normal group and the mild lower group was higher than that in the moderate and severe low level group,and the difference was statistically significant(P<0.05).The incidence of acute radiation-induced esophagitis in the low serum albumin group was higher than that of the normal group,and the incidence of acute radiation-induced esophagitis in the high PLR group was significantly higher than that of the low PLR group,and the difference was statistically significant(P<0.05).The incidence of acute hematological adverse reaction in the normal group and the mild lower group was significantly lower than that in the moderate and severe low level group,and the difference was statistically significant(P<0.05).Multiple regression analysis showed that serum albumin and PLR were significantly related to acute radiation-induced esophagitis.The total lymphocyte count was significantly related to the adverse reaction of acute blood system.Conclusion Serum albumin and PLR in patients with esophageal cancer with concurrent chemoradiotherapy are the influencing factors of acute radiation-induced esophagitis.The total lymphocyte count is the influencing factor of acute hematological adverse reactions,and should be paid attention to treatment of radiotherapy and chemotherapy.
作者
温翠侠
孙凌飞
吴承俊
Wen Cuixia;Sun Lingfei;Wu Chengjun(Xuzhou City Center Hospital,Xuzhou 221000,China)
出处
《北华大学学报（自然科学版）》
CAS
2019年第1期77-81,共5页
Journal of Beihua University（Natural Science）
基金
江苏省自然科学基金项目(B20140232)
关键词
食管癌
放疗
急性不良反应
营养状况指标
炎症指标
esophageal cancer
radiotherapy
acute adverse reactions
nutritional status indicators
inflammatory markers
