放射治疗前血红蛋白水平对原发性肝癌疗效的影响

Effect of hemoglobin level before radiation therapy on the patients with primary hepatocarcinoma

目的探讨原发性肝癌放射治疗前血红蛋白浓度对放射治疗效果的影响。方法收集2012年12月至2014年10月东方肝胆外科医院放疗科收治的90例接受放射治疗的原发性肝癌患者的临床、随访资料,根据放射治疗前患者血红蛋白浓度分为高血红蛋白组(≥120 g/L)和低血红蛋白组(<120 g/L),全部病例均接受根治性放疗,比较2组间肿瘤有效缓解率、1年生存率、总体生存时间等的差异。结果近期疗效评价:高血红蛋白组有效缓解率为51.4%,低血红蛋白组有效缓解率为22.6%,差异有统计学意义(P<0.05)。远期疗效评价:高血红蛋白组1年生存率(40.5%)显著高于低血红蛋白组(20.8%)(P<0.05);2组患者总体生存期差异有统计学意义(P<0.01)。多因素Cox分析提示:放疗前血红蛋白低于正常值、谷丙转氨酶(AST)及凝血酶原时间(PT)高于正常值、可检测到乙肝病毒DNA复制以及直径大于5 cm肿瘤,均提示患者总体生存时间更短。结论放射治疗前血红蛋白的水平是影响接受放射治疗的原发性肝癌患者总体生存期的重要独立风险因素。

Objective To investigate the effect of hemoglobin level before radiation therapy on the patients with primary hepatocarcinoma Methods Clinical and medical follow-up data of 90 cases of hepatocarcinoma admitted into the hospital from December2012 to October 2014 for radiation therapy were collected for the study. In accordance with the hemoglobin levels,the patients were divided into the high hemoglobin level group（ ≥120 g / L） and the low hemoglobin level group（〈120g/L）,and all the patients received radical radiotherapy. Then,data concerning remission rate,1 year survival rate and overall survival time were compared between the 2 groups. Results With regard to the short-term therapeutic effect evaluation,the remission rate of the high hemoglobin level group was 51. 4%,while that of the low hemoglobin level group was 22. 6%,and statistical significance could be noticed,when comparisons were made between the 2 groups（ P〈0. 05）. With respect to the long-term therapeutic effect evaluation,1 year survival rate of the high hemoglobin level group（ 40. 5%） was significantly higher than that of the low hemoglobin level group（ 20. 8%）（ P〈0. 05）. Statistical significance could be found in overall survival time,when comparisons were made between the 2 groups（ P〈0. 01）. Multiple-factor Cox analysis indicated that the patients with low Hb level,and high AST and PT levels before radiotherapy could be detected to have HIV C DNA replication and the diameters of tumors were larger than 5cm. All this indicated that overall survival time of these patients was obviously shorter. Conclusion Hemoglobin level before radiation therapy was an important independent risk factor for the overall survival time of the radiation therapy patients with hepatocarcinoma.