摘要
目的分析放疗联合内分泌治疗期间前列腺癌患者血红蛋白变化情况及影响因素,并初步探讨血红蛋白减低程度与远期预后关系。方法回顾分析2011-2015年间北京大学第一医院放疗科放疗合并内分泌治疗的145例前列腺癌患者联合治疗期间血红蛋白变化情况。放疗采用常规分割IMRT技术,内分泌治疗采用联合雄激素阻断。结果放疗联合内分泌治疗期间血红蛋白减少中位值为8 g/L。放疗前患者血红蛋白基线、盆腔照射、GS评分越高,治疗期间患者血红蛋白降低越明显(P<0.001),盆腔放疗增加患者治疗期间血红蛋白减低趋势(86.8%∶72.8%,P=0.05)。患者放疗前内分泌治疗时间(P=0.53)和单纯内分泌治疗期间患者血色素的变化(P=0.837)与后续放疗期间血色素减低程度无关。血红蛋白明显减低组患者与轻度减低组患者年无生化失败率相似(P=0.686)。结论放疗前血红蛋白基线水平与联合治疗期间血红蛋白减少呈负相关。盆腔放疗与联合治疗期间血红蛋白减少呈正相关。患者治疗期间血红蛋白减低程度与患者远期生化失败无关。
Objective To analyze the influencing factors of hemoglobin changes in prostate cancer patients during radiotherapy combined with androgen-deprivation therapy(ADT)and analyze the relationship between the hemoglobin changes and long-term prognosis.Methods The changes of hemoglobin levels in 145 prostate cancer patients treated with radiotherapy combined with ADT in Department of Radiation Oncology of Peking University First Hospital from November 2011 to May 2015 were retrospectively analyzed.Intensity-modulated radiotherapy(IMRT)was employed for conventionally fractionated radiotherapy.Luteinizing hormone-releasing hormone agonist was utilized for endocrine therapy.Results The median hemoglobin reduction during radiotherapy combined with ADT was 8 g/L.The higher the baseline level of hemoglobin,pelvic irradiation and GS score before radiotherapy,the more obvious the decrease of hemoglobin during treatment(all P<0.001).Pelvic radiotherapy significantly increased the decline tendency of hemoglobin throughout the combined treatment(86.8%vs.72.8%,P=0.05).The duration of endocrine therapy before radiotherapy and the hemoglobin changes during endocrine therapy alone were not significantly correlated with the degree of hemoglobin decline during subsequent radiotherapy(P=0.53 and 0.837).The biochemical failure-free survival did not significantly differ between patients with significant and mild hemoglobin reduction(P=0.686).Conclusions The baseline level of hemoglobin before radiotherapy is negatively correlated with the decrease of hemoglobin during combined therapy.Pelvic radiotherapy is positively correlated with hemoglobin reduction during combined therapy.Hemoglobin reduction during combined therapy is not associated with the long-term biochemical failure-free survival of patients.
作者
李晓颖
高献书
李洪振
秦尚彬
李晓梅
张敏
马茗微
亓昕
白赟
Li Xiaoying;Gao Xianshu;Li Hongzhen;Qin Shangbin;Li Xiaomei;Zhang Min;Ma Mingwei;Qi Xin;Bai Yun(Department of Radiation Onclogy,Peking University First Hospital,Beijing 100034,China)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2020年第12期1043-1047,共5页
Chinese Journal of Radiation Oncology
基金
北京大学第一医院科研种子基金项目(2018SF084)
北京大学第一医院科研基金资助课题(2017QN05)。
关键词
血红蛋白
前列腺癌/放射疗法
前列腺癌/内分泌疗法
预后
Hemoglobin
Prostate cancer/radiotherapy
Prostate cancer/androgen-deprivation therapy
Prognosis
