中晚期宫颈癌放疗效果与血红蛋白浓度关系的研究

Influence of peripheral blood hemoglobin on the result of radiotherapy for middle-advanced cervical carcinoma

目的 探讨中晚期宫颈癌放射治疗后近期、远期疗效与血红蛋白浓度的关系。方法 1 997年 1月至 1 2月 335例病理证实的中晚期宫颈癌患者在我科接受根治性放疗 ,体外照射采用 6或 8MV X线全盆腔野 30Gy/ 1 5次 ,中央遮盖野 2 0Gy/ 1 0次 ,腔内后装放疗192 IrA点 (35～ 4 5 )Gy/ (5～ 7)次。部分患者因宫颈“大菜花”肿瘤加用插植放疗 1～ 2次。放疗前中后测定血红蛋白含量 ,按治疗前血红蛋白浓度分成正常 ,轻、中、重度贫血 4组。结果 所有患者均随访 ,随访率 89% ,放疗中持续中重度贫血对中晚期宫颈癌的局部控制率和远期疗效有明显影响。

Objective To determine the influence of peripheral blood hemoglobin on the radiotherapy results of middle advanced cervical carcinoma. Methods From January to December 1997, 335 patients with middle advanced cervical carcinoma underwent radiation therapy. They received external beam radiotherapy with 6 or 8 MV X ray 30Gy/15 fractions to pelvic field and 20Gy/10 fractions to four fields of pelvis. At the same time, they also received afterloading radiotherapy with 192 Ir (35～45)Gy/(5～7) fractions on point A. The patients with local advanced cervical carcinoma added insert-needle radiotherapy 1～2 fractions. The peripheral blood hemoglobin concentration for all patients was measured before, during and after radiotherapy. These patients were divided into four groups according to the peripheral blood hemoglobin concentration before radiotherapy. They were normal blood hemoglobin concentration, or light, middle and heavy anemia. Results All patients were followed with a follow-up rate of 89%. There were significant effects for middle advanced cervical carcinoma that they were middle and heavy anemia. Conclusion The lower peripheral blood hemoglobin concentration affected effects of middle advanced cervical carcinoma on radiotherapy.