2016 年第 5 期 第 14 卷

阿米福汀对直肠癌同步放化疗患者的保护作用

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关键词：阿米福汀直肠癌适形调强放疗保护作用

• 摘要：
• 【摘要】目的 探讨阿米福汀对直肠癌同步放化疗患者的保护作用。方法 选取我院80例经病理组织学证实的直肠癌患者，随机分为治疗组和对照组，各40例。80例患者均行盆腔适形调强放射治疗：50Gy/25-28f；同步化疗：希罗达825 mg/m2，每天2次，每周5天，直至放疗结束。治疗组在同步放化疗基础上加用阿米福汀：放疗前30 min应用阿米福汀300 mg/m2静滴，15 min滴完。观察2组患者的不良反应，并进行对比分析。结果 治疗组2～4级急性直肠炎的发生率明显低于对照组（12.5% vs 32.5%），差异有统计学意义（P＜0.05）。两组均无3～4级泌尿系统不良反应发生。治疗组粒细胞减少发生率明显低于对照组，差异有统计学意义（P＜0.05）。阿米福汀相关性不良反应：低血压2例、III度呕吐1例、面部温热感1例；无因阿米福汀相关不良反应而中断治疗者。结论 阿米福汀可避免或减轻放化疗带来的毒副反应，值得临床推广应用。
• Objective To observe the protective efficacy of Amifostine in the concurrent radiochemotherapy for patients with rectal carcinoma. Methods Eighty patients with rectal carcinoma confirmed by pathology were randomly divided into treatment group and control group, each group were 40 cases. All eighty patients were treated by intensity modulated radiation therapy (IMRT): 50Gy/25-28f; and concurrent chemotherapy: xeloda 825mg/m2, twice daily, for 5 days every week until the end of radiotherapy. The patients in the treatment group were treated by the same radiochemotherapy, combined with intravenous Amifostine of 300 mg /m2, in 15 min before 30 min radiotherapy. The toxicities of radiochemotherapy in the two groups were observed and comparative analyzed. Results The incidences of grade 2～4 of acute proctitis were 12.5% and 32.5% in the treatment group and the control group respectively, with a significant difference between them (P＜0.05). No grade 3～4 of acute cystitis was found in two groups. The treatment group had lower frequencies of neutropenia, with a significant difference between them (P＜0.05). Amifostine-related adverse reactions: 2 cases of hypotension, 3 cases of grade 3 vomiting, warm sensation of face in 1case. None of participants had to discontinue treatment due to amifostine-related adverse affects. Conclusion Amifostine can avoid or reduce radiochemotherapy side effects, which is worthy of clinical popularization and application.