鼻咽癌放疗效果与血红蛋白浓度关系的研究

Influence of peripheral blood hemoglobin on the results of radiotherapy for nasopharyngeal carcinoma

目的 探讨鼻咽癌放射治疗的生存率和局控率与血红蛋白浓度的关系。方法 自1993年3月至2000年6月收治经病理确诊的348例鼻咽癌患者的临床及随访资料,于放射治疗前根据血红蛋白（Hb）浓度分为正常组（Hb≥120 g/L）、轻度贫血组（95 g/L≤Hb〈120 g/L）和中重度贫血组（Hb〈95 g/L）。根据放疗中血红蛋白浓度的变化分为两组（血红蛋白浓度升高组及血红蛋白浓度降低组）。全部病例均于根治性放疗,常规分割,对其生存率及局控率予以观察分析。结果 血红蛋白浓度明显影响鼻咽癌患者的生存率,放疗前升高血红蛋白浓度可提高鼻咽癌患者的局控率,放疗中血红蛋白的升高及降低对鼻咽癌的生存率也有明显影响。结论 贫血—低血红蛋白引起血液携氧能力下降,可造成肿瘤乏氧,从而使肿瘤细胞对放射线抗拒,最后导致疗效降低,影响患者生存质量和生存率。升高血红蛋白可提高鼻咽癌生存率。

Objective To determine the influence of peripheral blood hemoglobin on the radiotherapy resuits of nasopharyngeal carcinoma （NPC）. Methods Clinical and follow- up date of 348 NPC patients who received definitive radiotherapy from March 1993 to June 2000 were collected. The patients were divided into three groups according to the peripheral blood hemoglobin concentration before radiotherapy nomal group （Hb≥120 g/L）,mild anemia group （95 g/L≤Hb 〈 120 g/L）,severe anemia group（Hb 〈95 g/L） and into two groups according to the change in the peripheral blood hemoglobin concentration during radiotherapy as increased and decreased groups. All patients received radical radiation, using conventional fractionation. The survival and local control rates were observed and analyzed. Results The peripheral blood hemoglobin concentraton had a significant effect on the survival of NPC patients. Increasing the peripheral blood hemoglobin concentration before radiotherapy can improve the local control rates of NPC patients. Its decrease on increase during radiotherapy affected the survival rate of NPC patients. Conclusion Anemia - hypohemoglobinenia leads to decrease of oxygen carring capacity of blood resahing in oxygen deficiency of tumor cells and their radiotherapy resistance. Therefore, this method is worthy of farther studies. Increasing the peripheral blood hemoglobin concentration can improve the survival of NPC patients.