血红蛋白水平影响食管癌放疗疗效的前瞻性研究

Influence of Peripheral Blood Hemoglobin Concentration on the Result of Radiotherapy for Esophageal Carcinoma

目的探讨促红细胞生成素干预对食管癌放疗疗效的影响情况。方法2000年7月-2001年02月，54例经病理证实的中晚期食管癌接受放射治疗的病例，治疗前血红蛋白浓度均小于100g／L，随机分成两组，一组为对照组，一组为治疗组。两组均采用6MV或者18MVX射线放射治疗，食管癌原发灶剂量60-68Gy，区域淋巴结剂量50-60Gy。对照组放疗过程中予以支持治疗，而干预组除支持治疗外，每周注射促红细胞生成素，3000IU／次，2／周，同时口服铁剂。放射治疗前、后均测定血红蛋白量。两组病例合并行影响生存时间因素的COX回归分析；对比两组局部控制率和生存率的差别。结果病变长度、血红蛋白变化值为生存时间的影响因素；干预组的局部控制时间与生存时间优于对照组。结论促红素的使用有益于食管癌放疗患者血红蛋白水平的提升，从而改善其局部控制率和生存率。

Objective To study the influence of peripheral blood hemoglobin concentration on the radiotherapy result of esophageal carcinoma（EPC）. Methods From July 2000 to February 2001,54 patients with pathologically confirmed EPC received radical radiation. The patients were divided randomly into treatment group and control group. All patients were irradiated by 6 MV or 18MV external beam with a total dose of 60-68Gy for the primary tumor and 50-60Gy for the local lymph nodes. In the course of radiotherapy,the patients of treatment group treat were injected EPO（ 3000IU, BIW）. The peripheral blood hemoglobin concentration for all patients was measured before and after radiotherapy. To analyze the influence of all factor on survival by COX model and compare the local control radio and survival radio of treatment group treat and control group. Results All patients were followed with a follow-up rate of 100%. The change of peripheral blood hemoglobin concentration and length of esophageal locus had a significant effect on the survival of EPC patients. Its decrease or increase during radiotherapy affected the survival and local control rates of EPC patients. Conclusions EPO can increased the peripheral hemoglobin concentration of Group treat and it affected the oxygen content in the blood of patients, then increased the local control and survival rates of EPC patients.