喜炎平注射液预防放射性食管炎的疗效分析

doi:10.3760/cma.j.cn371439-20210210-00025

摘要/Abstract

摘要：

目的探讨喜炎平注射液对食管癌根治性放化疗患者放射性食管炎的预防作用。方法选取江苏省人民医院放疗科2020年1月至9月收治的70例食管癌根治性放化疗患者,按照随机数字表法将患者分为试验组(n=35)和对照组(n=35)。对照组行标准同步放化疗,试验组行同步放化疗联合喜炎平治疗。比较两组患者治疗前后白细胞计数、中性粒细胞计数、降钙素原(PCT)、白细胞介素-6(IL-6)水平以及放疗期间发生放射性食管炎、放射性肺炎情况。结果对照组和试验组患者治疗前白细胞计数[4.57(2.52)×10⁹/L vs. 5.59(2.23)×10 ⁹/L]及中性粒细胞计数[2.95(1.66)×10⁹/L vs. 3.69(1.56)×10 ⁹/L]比较,差异均无统计学意义(Z=1.44,P=0.151;Z=1.52,P=0.130);两组患者治疗后白细胞计数[4.28(2.50)×10⁹/L vs. 4.25(1.88)×10 ⁹/L]及中性粒细胞计数[2.99(2.50)×10⁹/L vs. 2.94(1.61)×10 ⁹/L]比较,差异均无统计学意义(Z=0.67,P=0.503;Z=0.69,P=0.489);两组患者治疗后白细胞计数及中性粒细胞计数与治疗前比较,差异均无统计学意义(Z=0.77,P=0.443;Z=1.08,P=0.279;Z=1.06,P=0.289;Z=0.68,P=0.495)。两组患者治疗前血清炎症指标PCT[0.02(0.03)μg/L vs. 0.02(0.05)μg/L]及IL-6[0.04(0.21)μg/L vs. 0.04(0.12)μg/L]比较,差异均无统计学意义(Z=0.70,P=0.482;Z=0.77,P=0.439);两组患者治疗后血清炎症指标PCT[0.06(0.17)μg/L vs. 0.03(0.08)μg/L]及IL-6[0.10(0.25)μg/L vs. 0.01(0.08)μg/L]比较,差异均有统计学意义(Z=2.08,P=0.038;Z=2.92,P=0.003);试验组患者治疗后血清炎症指标PCT及IL-6较治疗前比较,差异均无统计学意义(Z=1.20,P=0.230;Z=1.19,P=0.235);对照组患者治疗后血清炎症指标PCT较治疗前上升,差异有统计学意义(Z=2.82,P=0.005),血清炎症指标IL-6水平较治疗前上升,但差异无统计学意义(Z=1.41,P=0.158)。治疗期间,两组患者发生放射性食管炎以Ⅰ~Ⅱ级居多,对照组24例,试验组28例;对照组发生Ⅲ~Ⅳ级放射性食管炎的患者8例,试验组1例,两组患者发生放射性食管炎比较,差异有统计学意义(χ²=10.34,P=0.035)。治疗期间大多数患者放射性肺炎评级为0级;对照组发生轻度放射性肺炎(Ⅰ~Ⅱ级)患者10例,试验组6例;对照组和试验组发生Ⅲ级放射性肺炎的患者各2例;两组均无Ⅳ级放射性肺炎发生,两组患者发生放射性肺炎比较,差异无统计学意义(χ²=1.34,P=0.720)。结论在食管癌放疗患者中使用喜炎平注射液能够预防治疗后血清炎症指标PCT水平的升高,降低放射性食管炎的严重程度。

关键词: 食管肿瘤, 放射疗法, 喜炎平, 放射性食管炎

Abstract:

Objective To investigate the preventive effect of Xiyanping injection on radioactive esophagitis in patients with radical radiotherapy and chemotherapy for esophageal cancer. Methods A total of 70 patients with esophageal cancer undergoing radical radiotherapy and chemotherapy were selected from the Department of Radiation Oncology of Jiangsu Provincial People's Hospital from January to September 2020. They were divided into experimental group (n=35) and control group (n=35) according to random number table method. The control group received standard concurrent radiotherapy and chemotherapy, and the experimental group received concurrent radiotherapy and chemotherapy combined with Xiyanping. The white blood cell count, neutrophil count, procalcitonin (PCT) and interleukin-6 (IL-6) levels before and after treatment were compared between the two groups, as well as the occurrences of radioactive esophagitis and radioactive pneumonia during radiotherapy. Results Before treatment, there were no significant differences in white blood cell count [4.57 (2.52)×10⁹/L vs. 5.59 (2.23)×10 ⁹/L] and neutrophil count [2.95 (1.66)×10⁹/L vs. 3.69 (1.56)×10 ⁹/L] between the control group and experimental group (Z=1.44, P=0.151; Z=1.52, P=0.130). After treatment, there were no statistically significant differences in white blood cell count [4.28 (2.50)×10⁹/L vs. 4.25 (1.88)×10 ⁹/L] and neutrophil count [2.99 (2.50)×10⁹/L vs. 2.94 (1.61)×10 ⁹/L] between the two groups (Z=0.67, P=0.503; Z=0.69, P=0.489). There were no statistically significant differences in white blood cell count and neutrophil count between the patients after treatment and before treatment in the two groups (Z=0.77, P=0.443; Z=1.08, P=0.279; Z =1.06, P=0.289; Z=0.68, P=0.495). Before treatment, there were no statistically significant differences in serum inflammation indexes PCT [0.02 (0.03) μg/L vs. 0.02 (0.05) μg/L] and IL-6 [0.04 (0.21) μg/L vs. 0.04 (0.12) μg/L] between the two groups (Z=0.70, P=0.482; Z=0.77, P=0.439). After treatment, there were statistically significant differences in serum inflammation indexes PCT [0.06 (0.17) μg/L vs. 0.03 (0.08) μg/L] and IL-6 [0.10 (0.25) μg/L vs. 0.01 (0.08) μg/L] between the two groups (Z=2.08, P=0.038; Z=2.92, P=0.003). There were no statistically significant differences in serum inflammation indexes PCT and IL-6 in the experimental groups after treatment compared with before treatment (Z=1.20, P=0.230; Z=1.19, P=0.235). In the control group, the serum inflammation index PCT level increased after treatment compared with before treatment, with a statistically significant difference (Z=2.82, P=0.005), and the serum inflammation index IL-6 level increased compared with before treatment, but with no statistically significant difference (Z=1.41, P=0.158). During the treatment, the incidence of radioactive esophagitis in the two groups was mainly grade Ⅰ-Ⅱ, with 24 cases in the control group and 28 cases in the experimental group. There were 8 patients with grade Ⅲ-Ⅳ radioactive esophagitis in the control group and 1 in the experimental group. There was a statistically significant difference in the occurrence of radioactive esophagitis between the two groups (χ²=10.34, P=0.035). During the treatment period, most patients with radioactive pneumonia were rated as grade 0. There were 10 cases of mild radioactive pneumonia (grade Ⅰ-Ⅱ) in the control group had and 6 cases in the experimental group. There were 2 cases of grade Ⅲ radioactive pneumonia in the control group and experimental group respectively. There was no grade Ⅳ radioactive pneumonia in either group. There was no significant difference in radioactive pneumonia between the two groups (χ ²=1.34, P=0.720). Conclusion Xiyanping injection can prevent the rise of serum inflammatory index PCT and reduce the severity of radioactive esophagitis in patients with esophageal cancer after treatment.

Key words: Esophageal neoplasms, Radiotherapy, Xiyanping, Radioactive esophagitis

刘佳, 葛小林, 狄晓珂, 史玉静, 曾玉婷. 喜炎平注射液预防放射性食管炎的疗效分析[J]. 国际肿瘤学杂志, 2022, 49(3): 146-150.

Liu Jia, Ge Xiaolin, Di Xiaoke, Shi Yujing, Zeng Yuting. Efficacy analysis of Xiyanping injection on prevention of radioactive esophagitis[J]. Journal of International Oncology, 2022, 49(3): 146-150.

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参考文献 11

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临床病理特征	对照组 (n=35)	试验组 (n=35)	t/χ²/Z值	P值
年龄(岁)	69.51±9.18	66.74±7.14	1.41	0.163
男	31	28	0.97	0.324
女	4	7
PS评分(分)
0	4	5	0.13	0.720
1	31	30
肿瘤部位
颈段	7	3
胸上段	9	8	2.25	0.522
胸中段	9	11
胸下段	10	13
肿瘤长度(cm)	5.00(2.00)	5.00(3.00)	0.25	0.806
放疗剂量(Gy)	52.65±4.31	52.99±4.47	0.33	0.745

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