老年直肠癌患者盆腔放疗的急性血液学毒性

Acute hematologic toxicity in elderly rectal cancer patients treated with pelvic radiotherapy

目的 探究老年直肠癌患者盆腔放疗的急性血液学毒性反应的发生率及其影响因素。方法 回顾分析2006年1月至2014年8月在本院行盆腔放疗的50例75岁及以上直肠癌患者的临床资料。选取同一时期行盆腔放疗的111例75岁以下直肠癌患者作为非老年患者组进行比较。采用卡方检验及Logistic多因素回归模型分析不同临床因素与3~4度血液学毒性发生率的相关性。结果 老年患者组中0度、1~2度、3~4度急性血液学毒性发生率分别为6.0%、78.0%和16.0%，非老年患者组中0度、1~2度、3~4度急性血液学毒性发生率分别为24.3%、68.5%和7.2%。老年患者的3~4血液学毒性反应发生率高于非老年患者（P=0.009）。多因素分析显示体重指数与老年患者的3~4度急性血液学毒性反应发生显著相关（P=0.038）。结论 老年直肠癌患者盆腔放疗的急性血液学毒性反应是可耐受的，高体重指数可能与老年患者盆腔放疗的严重血液学毒性反应相关。

Objective To explore the incidence and influential factors of acute hematologic toxicity in elderly rectal cancer patients treated with pelvic radiotherapy. Methods Fifty elderly patients aged 75 and older with rectal cancer, who were treated with pelvic radiotherapy at our hospital, were retrospectively analyzed. 111 non-elderly patients under 75 years of age, who were treated with pelvic radiotherapy in the same period, were selected as a control group. The relationship between clinical characteristics and incidence of grade 3~4 hematologic toxicity were analyzed by using chi-square test and multinomial logistic regression.Results In the elderly patient group, the incidence of grade 0, grade 1~2, grade 3~4 hematologic toxicity were 6.0%, 78.0%, and 16.0%, respectively. In the non-elderly patient group, the incidence of grade 0,grade 1~2, grade 3~4 hematologic toxicity were 24.3%, 68.5%, and 7.2%, respectively. The incidence of grade 3~4 hematologic toxicity in elderly patients was higher than that in non-elderly patients (P=0.009).Multivariate analysis showed that the body mass index was significantly correlated with the incidence of grade 3~4 hematologic toxicity in elderly patients (P=0.038). Conclusions Acute hematologic toxicity induced by pelvic radiotherapy was well tolerated in elderly patients with rectal cancer. High body mass index may be associated with severe hematologic toxicity in elderly patients.