交替半身照射治疗急性白血病的临床分析

Effects of alternate half-body irradiation on acute leukemia

目的评价60Co交替半身照射(AHBI)治疗急性白血病(M3除外)的疗效。方法对14例化疗缓解后的急性白血病(M3除外)患者强化预处理后行60Co交替半身照射(AHBI),观察临床症状、血象、骨髓象等变化,照射后未复发患者不用化疗,照射后急性淋巴细胞性白血病(急淋)与急性非淋巴细胞性白血病(急非淋)比较疗效,并与同期未照射患者比较疗效。结果 14例患者经AHBI后,5年后现存活4例,均为急淋患者,其中有2例已超过10年;死亡10例,其中急淋2例,急非淋8例,照射期间无一例死亡,照射组急淋与急非淋疗效比较差异有统计学意义(P<0.05)。同期未照射组能坚持巩固、维持化疗患者18例(7例急淋5年内均死亡,11例急非淋5年后存活1例),与照射组比较差异有统计学意义(P<0.05);缓解后未维持化疗48例,无一例存活5年以上,与照射组比较差异有统计学意义(P<0.01)。结论 60Co交替半身照射可作为急性白血病的一种治疗手段,但仅适用于无条件做骨髓移植的急淋患者,不适用于急非淋患者。

Objective To access the effects of alternate half-body irradiation（AHBI） on acute leukemia（AL）（M3 excepted）.MethodsFourteen patients with acute leukemia（M3 excepted） of complete remission received ^60Co AHBI after chemotherapy and pretreatment with high-dose chemotherapy,changes of blood and bone marrow figures were observed.Chemotherapy were cancelled for those had remission after AHBI,the curative effect were evaluated among patients with acute lymphatic leukemia（ALL）,acute nonlymphocytic leukemia（ANLL） and patients without irradiation.ResultsFour ALL cases survived after 5 years（2 cases have survived more than 10 years）,2 ALL cases and 8 ANLL cases died in 5 years but no death happened during irradiation.Curative effect difference between patients with ALL and ANLL,maintain chemotherapy group and AHBI group,no maintain chemotherapy and AHBI group（P〈0.05）.Conclusion^60Co AHBI is an effective therapy to acute lymphatic leukemia especially for those without bone marrow transplantation.