血红蛋白浓度与中晚期食管癌放疗疗效的相关性分析

Analysis of the relevance between peripheral blood hemoglobin concentration and prognosis of radiotherapy for esophageal carcinoma

目的:分析血红蛋白浓度对中晚期食管癌放疗疗效的影响。方法:1997年1月～1998年12月,经病理证实、接受根治性放疗的106例初治中晚期食管癌病例,采用6MV或者18MVX射线放射治疗,食管癌原发灶剂量60～70Gy,区域淋巴结剂量50～60Gy。放射治疗前、后均测定血红蛋白量。先进行局部控制时间、生存时间与相关影响因素的COX回归分析,得出其相关影响因素。放射治疗后根据血红蛋白浓度变化分为二组(血红蛋白升高组及血红蛋白降低组),分析放疗前后血红蛋白浓度及变化值对局部控制率、生存率的影响。结果:病变长度、淋巴结转移与否、大体病理类型和放疗后血红蛋白浓度/放疗前后血红蛋白浓度变化值为食管癌放疗后局控时间和生存时间的相关影响因素。放疗后血红蛋白浓度和放疗前后血红蛋白浓度变化值明显影响食管癌的局控率和生存率。结论:食管癌放疗过程中,血红蛋白浓度逐渐升高者,肿瘤的局部控制率及生存率优于降低者。

Objective ：To analyze the influence of peripheral blood hemoglobin concentration on the radiotherapy result of esophageal carcinoma （EPC）. Methods： From January 1997 to December 1998, 106 patients with pathologically confirmed AEPC received radical radiation. All patients were irradiated by 6 MV or L8 MV external beam with a total dose of 60 - 70Gy for the primary tumor and 50 - 60Gy for the local lymph nodes, The peripheral blood hemoglobin concentration for all patients was measured before and after radiotherapy. These patients were divided into two groups according to the change in the peripheral blood hemoglobin concentration during radiotherapy as increased and decreased groups. To analyse the factors relevant to local control time and survival of EPC by COX Regression. To compare the local control radio and survival ratio between increase group and decrease by Kaplan-Meier. Results： All patients were followed with a follow-up rate of 96. 2%. The peripheral blood hemoglobin concentration had a significant effect on the local control and survival of EPC patients. The length of locus, the local lymph node, pathological type and peripheral blood hemoglobin concentration were related to local control and survival. The decrease or increase of blood hemoglobin concentration during radiotherapy affected the survival and local control rates of EPC patients. Conclusion：The change of peripheral hemoglobin concentration can influence the local control and survival rates of EPC patients. Increase results in higher local control and survival.