关键词: 粒子放疗, 质子重离子放疗, 重离子放疗, 光子放疗, 骨髓功能, 肝功能, 肾功能

Abstract:

Objective To investigate the influence of particle radiotherapy on bone marrow，liver and kidney functions in prostate cancer patients. Methods A total of 23 prostate cancer patients undergoing photon radiation（photon radiation group），25 prostate cancer patients undergoing heavy ion radiation（heavy ion radiation group），28 prostate cancer patients undergoing proton heavy ion radiation（proton heavy ion radiation group） were enrolled，and according to treatment plans，each group was classified into simple radiotherapy and synchronous endocrine therapy subgroups. White blood cell（WBC） count，the absolute value of lymphocytes（LYMPH#），hemoglobin（Hb） and platelet（PLT） count were determined before and after treatment for all prostate cancer patients，in order to reflect bone marrow function suppression. The levels of albumin（Alb），total bilirubin（TB），alanine aminotransferase（ALT），aspartate aminotransferase（AST），creatinine（Cr） and urea were determined before treatment. Common Terminology Criteria for Adverse Events（CTCAE） version 5.0 was used. The liver and kidney functions before and after treatment in 15 patients undergoing synchronous endocrine therapy and photon radiation and 13 patients with synchronous endocrine therapy were determined and compared. Results There was no statistical significance in WBC count，Hb，PLT count，TB，ALT and urea in photon radiation group，heavy ion radiation group and proton heavy ion radiation group before treatment（P>0.05）. There was statistical significance in Alb，AST，Cr and LYMPH# among the 3 groups（P<0.05）. The proportion of LYMPH # grade Ⅰ patients after heavy ion radiation was higher（100%，12/12） than those after photon radiation（50%，4/8） and proton heavy ion radiation（50%，4/8）（P=0.015）. The proportion of patients with LYMPH# grade Ⅰ after synchronous endocrine therapy of heavy ion radiation（100%，13/13） was higher than that of photon radiation（33%，5/13） and proton heavy ion radiation（35%，7/20）（P=0.002）. After the synchronous endocrine therapy of heavy ion radiation and proton heavy ion radiation，the proportions of Hb grade Ⅰ were 100%（13/13，20/20），which was higher than that of photon radiation（73%，11/15）（P=0.048）. After photon radiation combined with endocrine therapy，serum ALT level was higher than that before treatment（P=0.005），and serum Cr level was lower than that before treatment（P=0.026）. There was no statistical significance in serum Alb，TB，AST and urea levels before and after treatment（P>0.05）. There was no statistical significance in Alb，TB，ALT，AST，Cr and urea before and after heavy ion radiation combined with endocrine therapy（P>0.05）. Conclusions The degree of bone marrow function suppression of heavy ion radiation is lower than that of photon radiation and proton heavy ion radiation，whether it is synchronous endocrine therapy or not. The suppression effect on liver and kidney functions is lower than that of photon radiation combined with endocrine therapy.

Key words: Particle radiotherapy, Proton heavy ion radiotherapy, Heavy ion radiotherapy, Photon radiotherapy, Bone marrow function, Liver function, Kidney function