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目的了解全脑全脊髓放疗对髓母细胞瘤患者血象的影响,分析其危险因素。方法回顾性地分析30例髓母细胞瘤患者在接受全脑全脊髓放疗期间血象变化,按照下降程度分为正常与轻度抑制(0/Ⅰ/Ⅱ)和重度抑制(Ⅲ/Ⅳ),分析性别、年龄、放疗累积剂量与血液学毒性的相关性。结果 96.7%(29/30)的患者出现白细胞减少,63.3%(19/30)的患者出现血小板减少,70%的患者在放疗开始2周内出现白细胞减少,放疗的累积剂量与血液学毒性有关(P<0.001)。结论大部分患者在前两周出现白细胞减少,放疗累积剂量(Dt)0～18 Gy出现血液学毒性的患者中发生重度抑制的白细胞血液学毒性的比例更高,放疗开始2周内出现白细胞减少比例高,应密切观察血象变化,发生血液学毒性时应及时处理。
Objective To investigate the effect of whole brain whole spinal cord radiotherapy on the hemogram of patients with medulloblastoma and to analyze its risk factors. Methods Thirty patients with medulloblastoma were retrospectively analyzed for hemogram after receiving whole-brain radiotherapy and divided into normal and mild inhibition (0 / Ⅰ / Ⅱ) and severe suppression (Ⅲ / Ⅳ) Gender, age, cumulative dose of radiotherapy and hematologic toxicity. Results Thrombocytopenia occurred in 96.7% (29/30) of patients, thrombocytopenia in 63.3% (19/30) and leukopenia in 70% of patients at the first 2 weeks of radiotherapy. The cumulative dose of radiotherapy was associated with hematological toxicity (P <0.001). Conclusions The majority of patients have leukopenia in the first two weeks, and the proportion of severe hematological toxicity of leukocytes is higher in patients with hematological toxicities between 0 and 18 Gy in radiotherapy dose (Dt). Leukopenia occurs within 2 weeks after radiotherapy A high proportion of blood should be closely observed changes in the occurrence of hematological toxicity should be promptly addressed.