促红素对Ⅲ期食管癌的放疗增敏作用  

Radiosensitization effect of recombined human erythropoietin on esophageal neoplasms with stage Ⅲ

作　　者：孙衍伟[1] 苏彤[1] 迟玉华[1] 刘山[1] 张可[1] 

机构地区：[1]山东省日照市人民医院肿瘤科,276800

出　　处：《中国实用医刊》2010年第15期30-32,共3页Chinese Journal of Practical Medicine

摘　　要：目的 评价促红素对Ⅲ期食管癌的放疗增敏作用及不良反应.方法 将62例欲接受根治性放疗的Ⅲ期食管癌患者随机分为试验组和对照组.试验组:在放疗前1周给予促红素3万U,皮下注射,每周1次,至放疗结束.放疗用6 MV X射线进行三维适行照射,DT 1.8～2.0 Gy/次,每周5次,中位剂量为DT 64 Gy.对照组行单纯三维适行照射,其设野和剂量同试验组,中位剂量为DT 65 Gy.结果 放疗DT 20 Gy时,试验组完全消退率(CR)为6.7%(2/30),对照组为6.7%(2/30),二者比较差异无统计学意义(χ2=0.2679,P=0.6048);放疗DT 40 Gy时,试验组CR为33.3%(10/30),对照组为16.7%(5/30),二者比较差异无统计学意义(χ2=2.2222,P=0.1360);放疗结束时,试验组CR为50.0%(15/30),对照组为26.7%(8/30),二者比较差异无统计学意义(χ2=3.4548,P=0.0631);放疗后1个月,试验组CR为63.3%(19/30),对照组为36.7%(11/30),二者比较差异有统计学意义(χ2=4.2667,P=0.0389);放疗后6个月,试验组CR为66.7%(20/30),对照组为40.0%(12/30),二者比较差异有统计学意义(χ2=4.2857,P=0.0384).两组在血液学毒性方面比较差异有统计学意义(χ2＝8.1481,P=0.0043).结论 促红素能明显提高Ⅲ期食管癌的放疗疗效,减轻放疗所致的血液学毒性,并可预见能延长患者的远期生存,值得临床上进一步试用推广.Objective To study the radiosensitization effect of recombined human erythropoietin (RHEpo) on esophageal neoplasms with stage Ⅲ. Methods From March 2004 to May 2008, 62 patients diagnosed esophageal neoplasms with stage Ⅲ were randomly divided into the treatment group or the control group. In the treatment group, RHEpo was administered at 30 000 U weekly during the course of three dimensional conformal radiotherapy and one week before radiation. The control group was only given three dimensional conformal radiotherapy. Radiation was administered with 6MV X-rays, 1.8-2.0 Gy per day and 5 times per week. Total dose was 60-70 Gy over 6-7 weeks, and the median doses were 64 Gy and 65 Gy, respectively.Results At the end of DT 20 Gy, complete remission rate (CRR) in both groups were 6.7% (2/31) (χ2=0.2679,P=0.6048), while DT 40 Gy was over, the CRR was 33.3% (10/30) and 16.7%(5/30) (χ2=2.2222,P =0.1360) respectively, when the whole radiotherapy was finished, the CRR was 50.0% (15/30) and 26.7% (8/30) (χ2=3.4548,P=0.0631) respectively, and one month and six months after radiotherapy, the CRR were 63.3% (19/30) and 66.7% (20/30) in the trial group, and 36.7% (11/30) and 40.0% (12/30) in the control group respectively (χ2=4.2667,P=0.0389; χ2=4.2857,P=0.0384). The rates of acute hematological toxicity were different in two groups (χ2＝8.1481,P=0.0043). Conclusions RHEpo can improve the clinical effect of patients diagnosed esophageal neoplasms with stage III who received radiotherapy, and decrease acute hematological toxicity caused by radiotherapy, and may elongate life time of these patients.

关 键 词：食管肿瘤 重组人促红细胞生成素 药物疗法 放射疗法 

分 类 号：R735[医药卫生—肿瘤]