放射治疗在脾脏相关疾病中的应用(附15年国内文献分析)

Application of splenic irradiation on spleen diseases(review of 15-years domestic literatures)

目的:总结我国脾区放射治疗的开展情况,治疗效果及预后,为脾区放疗的临床实施提供指导。方法:应用清华同方医学期刊数据库,检索1995年-2010年刊出脾区放射治疗的文章,建立数据库,进行统计分析。结果:共获得相关文献20篇,病例423例,接受脾区放疗的疾病有:血小板减少性紫癜、良恶性疾病合并脾大或脾亢、脾脏原发或继发恶性肿瘤、增强免疫力的脾区照射。治疗效果:脾大或脾亢放疗后脾脏缩小明显,白细胞、血小板均有明显改善,总有效率70%-90%;脾转移瘤放疗后完全缓解率达60%;低剂量脾区放疗后,提高NK细胞活性,可刺激外周血T淋巴细胞的CD3和CD4升高,增强患者免疫力。结论:脾区放疗疗效可靠,安全易行,不良反应小,是临床治疗脾相关疾病可选择的方法。

Objective： To provide the guidance for splenic irradiation in clinical through summarizing develop-ment, treatment effect and prognosis on splenic irradiation. Methods： To use the medico-periodical data base of Qinghuatongfang, retrieve the articles of radiotherapy of spleen from 1995 to 2010, establish data base. Results：A to-tal of 20 literatures ,423 cases ,the diseases received splenic irradiation： thrombocytopenic purpura, benign and ma-lignant disease with splenomegaly or hypersplenism, the spleen primary or secondary malignant tumors, splenic irra- diation enhancing the immune. Treatment effect： symptoms of splenomegaly or hypersplenism and blood counts after radiotherapy were significantly improved with the total effective rate of 70% -90% ;splenic metastasis after radiother-apy complete response rate was 60% ; low - dose splenic irradiation enhance NK cell activity and increase amounts of T lymphocytes with CD3 and CIM in peripheral blood as well as immune system ability in patients. Conclusion ：Splenic irradiation is one of alternative methods for clinical treatment of disorders associated spleen because of credi-bility, safe and easy, without recordable acute toxicity.