髓母细胞瘤患者全脑全脊髓放疗的血液学毒性观察  

Haematological toxicity of craniospinal irradiation in medulloblastoma

作　　者：赵向飞[1] 康静波[1] 聂青[1] 张军[1] 贾海威[1] 

机构地区：[1]海军总医院放射肿瘤科,北京100048

出　　处：《军事医学》2012年第5期385-387,共3页Military Medical Sciences

摘　　要：目的了解全脑全脊髓放疗对髓母细胞瘤患者血象的影响,分析其危险因素。方法回顾性地分析30例髓母细胞瘤患者在接受全脑全脊髓放疗期间血象变化,按照下降程度分为正常与轻度抑制(0/Ⅰ/Ⅱ)和重度抑制(Ⅲ/Ⅳ),分析性别、年龄、放疗累积剂量与血液学毒性的相关性。结果 96.7%(29/30)的患者出现白细胞减少,63.3%(19/30)的患者出现血小板减少,70%的患者在放疗开始2周内出现白细胞减少,放疗的累积剂量与血液学毒性有关(P<0.001)。结论大部分患者在前两周出现白细胞减少,放疗累积剂量(Dt)0～18 Gy出现血液学毒性的患者中发生重度抑制的白细胞血液学毒性的比例更高,放疗开始2周内出现白细胞减少比例高,应密切观察血象变化,发生血液学毒性时应及时处理。Objective To detemaine the haematological toxicity of craniospinal irradiation in medulloblastoma patients and evaluate its risk factom. Methods A retrospective study involving changes in hematology during craniospinal irradia- tion was conducted. Patients were divided into normal/mild uppression gronp （Ⅲ/Ⅳ ） and severe suppression group （ Ⅲ/Ⅳ ） according to the decline in the degree. The correlation of gender, age, radiatien and haematologieal toxicity was examined. Results The incidence of leucopenia was 96.7% （29/30） while that of thmmbocytopeuia was 63.3% （ 19/ 30 ）. Leucopenia appeared with in 2 weeks from the beginning of radiotherapy. Radiation was correlated with haematological toxicity. Conclusion The majority of patients developed leukopenia in the first two weeks, A higher proportion of serious leucopenia occurred in （Dt） 0 - 18 Gy. It is important to investigate the changes in hematology in the first two weeks of ra- diotherapy. Hematologic toxicity should be treated in time.

关 键 词：髓母细胞瘤 全脑全脊髓放疗 血液学毒性 

分 类 号：R739.4[医药卫生—肿瘤]