食管癌术后放疗骨照射剂量与骨髓抑制相关性

摘要

Objective: To investigate the relation between dose exposure of sternum, vertebra, other bone structures and bone marrow suppression in esophageal cancer patientsundergoing postoperative radiotherapy. Methods: Thirty-eight patients with esophageal cancer who underwent postoperative radiotherapy in our hospital were divided into two groups ( group A:grade <2 hematologic toxicity vs group B: grade≥2 hematologic toxicity) according to hematologic results. Sternum, verte-brae and other bone structures were contoured on planning computed tomography scans. Then the irradiation dose of each bone structures were compared between the two groups. Results: The Dmean,V5 ,V10 ,V20 of total bones, V5 ,V10 of sternum, V5 ,V10 ,V20 of vertebra of group A were higher than those of group B. The differences were statistically significant. Conclu-sion: The irradiation of sternum and vertebra makes more contribution to bone marrow suppression. Difference in the degree of bone marrow suppression in radiotherapywas attributed to lower dose exposure of bone structurerather than higher dose vol-ume.%目的:探讨食管癌术后放疗胸骨、椎体骨及其他骨结构受照剂量与发生骨髓抑制的关系.方法:选取我院行术后放疗的38例食管癌患者,根据血液学检查结果分为II度以下骨髓抑制组和II度以上骨髓抑制组,勾画胸骨、椎体骨及其他骨结构,计算并比较两组的骨受照射剂量.结果:II度以上骨髓抑制组总体骨Dmean、V5 、V10 、V20 ,胸骨V5 、V10 ,椎体骨V5 、V10 、V20均高于II度以下骨髓抑制组,其差异具有统计学意义.结论:胸骨及椎体骨照射剂量对骨髓抑制贡献较大.此外,骨结构低剂量(V5 、V10 )造成的骨髓抑制程度差异更明显,而非高剂量照射体积.