改善肿瘤细胞乏氧状态对非小细胞肺癌放疗效果的影响

 目的 为了观察改善肿瘤细胞的乏氧状态对非小细胞肺癌（NSCLC）放疗效果的影响。方法 随机选择Ⅱ~Ⅳ期的NSCLC患者42例，资料完整者38例，在放射治疗前30 min内，采用舒氧康静脉内给氧的方法，提高血液中的氧分压，改善肿瘤细胞的乏氧状态；给氧前、后分别作血气分析，然后及时给予放射治疗，每次2 Gy，每日1次，每周5 d，总剂量60 ~ 70 Gy，随机选取同期的常规普放NSCLC患者37例作对照，按WHO疗效评价标准评价疗效，并作统计学处理。结果 试验组内给氧前后的动脉氧分压（PO2）分别为（85.6±7.5）mmHg，（103±9.7）mmHg；内给氧前后的血氧饱和度（SaO2）分别为（89.5±6.1）%和（94.4±5.2）%；放疗有效率为63.16 %（24／38）。对照组的有效率为43.24 %（16／37），试验组的疗效优于对照组（0.05＜P＜0.1），而两组之间毒副反应的发生率差异无统计学意义（P）。结论 放疗前静脉内给氧可改善肿瘤细胞的乏氧状态，提高放射治疗效果。

Effects of improving tumor cell hypoxia on radiotherapy in non-small cell lung cancer

Objective To observe the effects of improving tumor cell hypoxia on radiotherapy in non-small cell lung cancer(NSCLC). Methods Forty-two patients with NSCLC on stage II to stage IV were en－rolled randomly, of whom 38 patients were well documented. All patients were treated with oxygenator by in－travenous oxygen delivery within thirty minutes before radiotherapy to increase partial pressure of blood oxy－gen and improve tumor cell hypoxia. The arterial blood gas was analysed for each patients before and after oxygen infusion. All patients receive radiotherapy at a dosage of 2 Gy each time per day, five times per week. The total dosage was 60 to 70 Gy. Another 37 NSCLC patients selected randomly in control group were treated by conventional radiotherapy. The therapeutic effects were analysed statistically according to WHO categorized standard. Results The mean pO2 was 85.6±7.5 mmHg, 103±9.7 mmHg, and SaO2 was 89.5±6.1 %, 94.4±5.2 % before and after oxygen infusion respectively in study group. The efficacy of radiotherapy was 63.16 %（24/38）, which was significantly higher than that in control group 43.24 % (16/37) (P < 0.05). No marked difference was noted in side-effects between the two groups. Conclusions Intravenous oxygen infusion may improve tumor cell hypoxia and improve the effects of radiotherapy.