低剂量分次照射脾脏提高食管癌放疗患者抗辐射作用的研究

目的探讨低剂量分次照射脾脏对食管癌放疗患者抗辐射能力及对机体正常组织的合理防护作用的影响.方法60例食管癌放疗患者随机分为联合组及对照组.联合组放疗配合低剂量辐射照射脾脏,对照组单纯放射治疗;采用乳酸脱氢酶释放法和碱性磷酸酶抗碱性磷酸酶桥联酶标技术法检测患者治疗前后细胞免疫指标.同时观察两组急性放射性食管炎、放射性气管炎和放射性肺炎的发生率及出现时间.结果治疗后细胞免疫指标NK细胞活性及CD4+、CD4+/CD8+比值联合组明显高于对照组(P＜0.05).急性放射性食管炎、放射性气管炎和放射性肺炎的发生率联合组为40.0%、36.7%和6.7%明显低于对照组的100.0%、76.7%和27.6%(P＜0.05).出现并发症时的平均放疗剂量联合组分别为49.23 Gy、42.25 Gy和64.00 Gy明显晚于对照组的28.17 Gy、22.56 Gy和42.53 Gy(P＜0.05).结论低剂量分次照射脾脏配合放疗治疗食管癌,可提高食管癌放疗患者的免疫功能和抗辐射能力.

EFFECTS OF LOW DOSE FRACTIONATED IRRADIATION ON SPLEEN TO IMMPROVE THE ANTI-IRRADIATION FUNCTION IN ESOPHAGEAL CARCINOMA

Objective : To sutdy the effects of low dose fractionated irradiation on spleen in esophageal carcinoma with radiotherapy . Methods : Sixty patients with esophageal carcinoma were randomized into combined group or control group . Thirty cases of combined group were treated with low dose fractionated irradiation on spleen and radiotherapy . The patients of control group were treated with radiotherapy alone . Activity of NK cells and T lymphocyte subsets in patients were measured respectively by LDH release and APAAP techniques.Results:The incidence of acute radiative esophagitis,trachitis and pneumonitis were 40.0 %,36.7 % and 6.7 % in combined group and 100.0 %,67.7 % and 27.6 % in control group ( P <0.05).The average dose of radiotherapy caused acute radiative esophagitis,trachitis and pneumontis were 49.23 Gy in control group ( P <0.05).After treatment,the activity of NK cells,CD 4 positive cells and CD + 4/CD + 8 values were significantly higher in combined group than in control group ( P <0.05).Conclusion:The results suggested that low dose radiation can stimulate the immun function,through which the threshold dose of radiotherapy increases without damaging the normal tissues.