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