重组人白细胞介素-11预防髓母细胞瘤术后放射治疗所致血小板减少的临床研究  

Clinical research on rhI L-11 application in preventing thrombocytopenia induced by postoperative radiotherapy of medulloblastoma

作　　者：方恒虎 康静波 赵向飞 吴姗珊 路泽军 

机构地区：[1]海军总医院肿瘤诊疗中心,北京100048

出　　处：《中国医学装备》2014年第11期104-107,共4页China Medical Equipment

基　　金：全军科技攻关项目(06G034)"中药与现代技术优化对恶性肿瘤的防治研究"

摘　　要：目的:评价重组人白细胞介素-11(rh IL-11)预防髓母细胞瘤术后放射治疗所致血小板减少的疗效和不良反应。方法:60例患者采用随机对照研究方法,将其分为A组(rh IL-11预防治疗组30例)和B组(对照组30例)。A组患者放射治疗中血小板计数<100×109/L时或血小板计数较放射治疗前基线水平下降>50%即开始按50μg?kg-1?d-1剂量给予rh IL-11皮下注射,每日1次连续应用,直至血小板计数≥200×109/L时停药;B组患者不予预防性应用rh IL-11治疗,但当血小板计数<50×109/L时则按50μg?kg-1?d-1剂量给予rh IL-11皮下注射治疗,每日1次连续应用,直至血小板计数≥100×109/L时停药。结果:本研究中54例患者可进行疗效评价。rh IL-11可显著升高髓母细胞瘤术后放射治疗中血小板的最低值,显著缩短血小板减少症的持续时间和缩短放射治疗所需的时间。主要不良反应有注射部位疼痛、硬结、红肿、水肿、乏力及心悸等,但大多程度较轻,且无其他严重不良反应。结论:rh IL-11具有明显的促血小板生成作用,可显著减少髓母细胞瘤患者术后放射治疗过程中血小板减少的发生率,保证放射治疗的顺利进行,且不良反应较轻,较易处理。Objective： The efficacy and adverse effect of rhIL-11, which is applied to prevent thrombocytopenia induced by postoperative radio therapy of medullablastoma is assessed. Methods： Enrolled patients are divided into two groups of A as well as B in accordance withrandomized controlling method. As long as platelet count fell down to the level of less than 100×109/L or that basement drop surpassed 50% compared with pre-radiotherapy, patients of group A were continuously medicated rhIL-11 in themanner of subcutaneous＇injection once per-day by＇dosage of 50μg·kg^-1·d^-1, before platelet count elevated more than 200× 109/L. Without prophylactic rhIL-11 medication, patients of group B were continuously treated with rhIL-11 in the manner of subcutaneous injection once per-day by dosage of 50μg·kg^-1·d^-1 so long as platelet count decreased less than 50× 109/L, until it was enhanced to the level of more than 100 × 109/L. Results： There were 54 cases available to treatment efficacy evaluation, from which it was observed that rhIL-11 could significantly increase minimum platelet count in the setting of postoperative radiotherapy of medulloblastoma, significantly shorten thrombocytopenia duration, significantly reduce platelet transfusion frequency, as well as significantly lessen radiotherapy time. Major adversereaction includes： Injection site pain, nodular, swelling, edema, tatigue and palpitation, most ot which were mild and absent of additional severe adverse reaction. Conclusion： The rhIL-11 contains apparent thrombopoietin effect, as well as obviously reduces thrombocytopenia occurrence induced by postoperative radiotherapy of medulloblastoma so that it secures smooth procession of radiotherapy. The adverse reaction is moderate and undifficult to handle with.

关 键 词：重组人白细胞介素-11 血小板减少症 预防 放射治疗 

分 类 号：R816.3[医药卫生—放射医学]