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目的评价60Co交替半身照射(AHBI)治疗急性白血病(M3除外)的疗效。方法对14例化疗缓解后的急性白血病(M3除外)患者强化预处理后行60Co交替半身照射(AHBI),观察临床症状、血象、骨髓象等变化,照射后未复发患者不用化疗,照射后急性淋巴细胞性白血病(急淋)与急性非淋巴细胞性白血病(急非淋)比较疗效,并与同期未照射患者比较疗效。结果 14例患者经AHBI后,5年后现存活4例,均为急淋患者,其中有2例已超过10年;死亡10例,其中急淋2例,急非淋8例,照射期间无一例死亡,照射组急淋与急非淋疗效比较差异有统计学意义(P<0.05)。同期未照射组能坚持巩固、维持化疗患者18例(7例急淋5年内均死亡,11例急非淋5年后存活1例),与照射组比较差异有统计学意义(P<0.05);缓解后未维持化疗48例,无一例存活5年以上,与照射组比较差异有统计学意义(P<0.01)。结论 60Co交替半身照射可作为急性白血病的一种治疗手段,但仅适用于无条件做骨髓移植的急淋患者,不适用于急非淋患者。
Objective To evaluate the efficacy of 60Co Alternate Half Body Irradiation (AHBI) in the treatment of acute leukemia (except M3). Methods Forty patients with acute leukemia (except M3) undergoing chemotherapy were treated with 60Co alternating half - body irradiation (AHBI) after intensive pretreatment. Clinical symptoms, hemogram and bone marrow imaging were observed. The patients without recurrence after chemotherapy were treated with chemotherapy, Lymphocytic leukemia (acute lymphoblastic leukemia) and acute non-lymphocytic leukemia (acute fecal lymph nodes) more curative effect, and compared with non-irradiated patients over the same period. Results After AHBI, 14 patients survived 5 years after operation. All of them were acute lymphoid leprosy patients, of which 2 cases had been over 10 years; 10 died, including 2 cases of acute lymphoblastic leaching and 8 cases of acute leprosy. In one case, the difference between the acute lymphoblastic and the non-lymphatic groups was statistically significant (P <0.05). In the same period of non-irradiation group, 18 patients were cured and maintained chemotherapy (7 cases of acute lymphoblastic leukemia were dead within 5 years and 11 cases were treated with acute lefemy 5 years later). There was significant difference between the two groups (P <0.05) 48 cases were not maintained after remission, and none of them survived for more than 5 years. The difference was statistically significant (P <0.01). Conclusion 60Co alternating half-body irradiation can be used as a treatment of acute leukemia, but only for unconditional bone marrow transplant patients with acute lymphoma, is not suitable for acute non-lymph node patients.