阿米福汀对直肠癌同步放化疗患者的保护作用

Protective effect of amifostine in the concurrent radiochemotherapy for patients with rectal carcinoma

目的：探讨阿米福汀（AMI）对直肠癌同步放化疗患者的保护作用。方法选取经病理组织学证实的直肠癌患者80例，随机分为治疗组和对照组，每组各40例。所有患者均予盆腔适形调强放射治疗及口服卡培他滨同步化疗。治疗组在同步放化疗基础上加用AMI治疗，观察两组患者的不良反应，并进行对比分析。结果治疗组Ⅱ~Ⅳ级急性直肠炎的发生率为12.5%，明显低于对照组的32.5%，差异具有统计学意义（P﹤0.05）；两组患者均无Ⅲ～Ⅳ级泌尿系统不良反应发生；治疗组中性粒细胞减少发生率为22.5%，明显低于对照组的45%，差异具有统计学意义（P﹤0.05）。AMI相关不良反应有：低血压2例，Ⅲ级呕吐2例，面部温热感1例；无因AMI相关不良反应而中断治疗者。结论 AMI可预防或减轻放化疗带来的不良反应，值得临床推广应用。

Objective To observe the protective effects of amifostine in the concurrent radiochemotherapy for pa-tients with rectal carcinoma. Method 80 patients with pathologically confirmed rectal carcinoma were randomized into study group or control group, with 40 cases in each. All patients were treated by general treatment of intensity modulated radiation therapy （IMRT） and oral capecitabine concurrent chemotherapy. While the patients in the study group were giv-en intravenous amifostine additionally on the basis of general treatment, the adverse reactions in both two groups were ob-served and comparatively analyzed. Result The incidence of acute proctitis of grade Ⅱ~Ⅳ was 12.5%, significantly lower in the study group compared with the control group at 32.5%（P〈0.05）;no acute cystitis of gradeⅢ~Ⅳwas found in neither groups;the incidence of neutropenia was 22.5%in study group, which was significantly lower than that of con-trol group at 45%（P〈0.05）. Amifostine-related adverse reactions included：2 cases of hypotension, 2 cases of gradeⅢvomiting, 1 case of flush;none of the subjects were discontinued due to amifostine-related adverse reactions. Conclusion Amifostine is effective in preventing or reducing side effects induced by radiochemotherapy, which is clinically practica-ble.