糖尿病合并食管癌患者采用后程加速超分割放疗所致不良反应及相关因素分析

Analysis of adverse effects and its related factors in patients with diabetes complicated with esophageal cancer caused by late accelerated hyperfractionated radiotherapy

目的探讨糖尿病合并食管癌患者后程加速超分割所致放疗不良反应及疗效相关因素。方法回顾性分析42例糖尿病伴有食管癌患者(研究组)和42例同期无糖尿病病史且血糖正常的食管癌患者(对照组)。两组均行后程加速超分放疗。观察比较两组患者放射性食管炎、放射性肺炎和放射性心脏损伤发生情况及相关因素。结果研究组Ⅲ~Ⅳ级放射性食管炎、放射性肺炎和放射性心脏损伤发生率均高于对照组(均P<0.05)。血糖≥7.0 mmol/L、糖尿病病史≥5年和联合化疗者Ⅲ~Ⅳ级放射性食管炎、放射学肺炎和放射学心脏损伤的发生率均较高(均P<0.05)。结论有、无糖尿病及血糖高低、病史长短及是否联合化疗是食管癌放疗患者发生严重放射性食管炎、放射性肺炎和放射性心脏损伤的危险因素。

Objective To investigate the adverse effects of radiotherapy and its related factors in patients with diabetes complicated with esophageal cancer caused by late accelerated hyperfractionated radiotherapy.Methods Forty-two patients with diabetes complicated with esophageal cancer(study group)and 42 patients with esophageal cancer without diabetes and with normal blood glucose level(control group)were analyzed retrospectively.Patients in both groups received late course accelerated hyperfractionation radiotherapy.The incidences of radiation esophagitis,radiation pneumonitis,radiation heart injury and related factors were compared between the two groups.Results The incidences of gradeⅢ-Ⅳradiation esophagitis,radiation pneumonitis and radiation heart injury in the study group were significantly higher than those in the control group(all P<0.05).The incidences of blood glucose≥7.0 mmol/L,diabetes history≥5 years,and gradeⅢ-Ⅳradiation esophagitis,radiation pneumonitis and radiation heart injury in patients with chemotherapy increased significantly(all P<0.05).Conclusion The risk factors of severe radiation esophagitis,radiation pneumonitis and radiation heart injury in esophageal cancer patients with radiotherapy are diabetes,high blood glucose level,the length of history,and combined chemotherapy.