中国癌症杂志
中國癌癥雜誌
중국암증잡지
CHINA ONCOLOGY
2013年
1期
1-9
,共9页
梅欣%章倩%刘迎玫%陈佳艺%章真%郭小毛
梅訢%章倩%劉迎玫%陳佳藝%章真%郭小毛
매흔%장천%류영매%진가예%장진%곽소모
阿米福汀%辐射防护剂%辐射损伤%大鼠
阿米福汀%輻射防護劑%輻射損傷%大鼠
아미복정%복사방호제%복사손상%대서
Amifostine%Radiation-protective agents%Radiation injuries%Rats
背景与目的:放射性肺损伤是胸部肿瘤放射治疗后的常见并发症,在放射治疗中如何保护肺组织免受或少受放射性损伤显得非常重要.本研究采用阿米福汀作为放射保护剂,探讨其对采用胸壁切线放射治疗技术照射大鼠肺组织放射性损伤的保护作用.方法:将35只雌性Fish-344大白鼠编号后按随机数字法分为常规照射部分和单次照射部分.常规照射部分:20只给予照射5周,总剂量为50 Gy,共25次.随机分为2组,用药照射组10只(随机照射左侧、右侧各5只);对照照射组10只(随机照射左侧、右侧各5只).单次照射部分:15只右侧胸部切线单次照射20 Gy,随机分为用药照射组5只,对照照射组5只,空白对照组5只.用药照射组照射前30 min内腹腔注射阿米福汀(140 mg/kg),对照照射组用相同剂量照射.采用60Co治疗机,前后野半野对穿照射.照射结束后记录呼吸频率、体质量,尾静脉取血测转化生长因子-β1(transforming growth factor-β,TGF-β),取大鼠照射侧肺及对照组同侧肺进行TGF-β1免疫组织化学染色.结果:常规照射部分用药照射组在放射后4周呼吸频率达到最高,对照照射组在放射后2周达到最高,差异有统计学意义(P<0.05).单次照射部分对照照射组升高较用药照射组差异有统计学意义(P<0.05).常规照射部分及单次照射部分中用药照射组与单纯照射组各段时间内的血清TGF-β1差异无统计学意义(P>0.05).在常规照射部分,肺组织HE染色和马松染色显示,与正常肺泡壁比较,单纯照射组的肺泡壁明显增厚,其肺泡间质大部分为增生纤维组织和弹力纤维组织.而在照射加药组虽也有肺泡壁增厚和纤维化,但与单纯照射组相比较不甚明显,可见大部分肺泡结构存在,肺泡壁的纤维化增生较单纯照射组减轻.免疫组织化学TGF-β1染色显示正常组织为阴性或弱阳性的表达,单纯照射组的肺组织TGF-β1染色表达多为阳性或中强阳性,照射加药组表达为弱阳性或阳性.在常规照射期间,用药照射组在放疗开始后体质量明显下降,而对照照射组体质量下降不明显,差异有统计学意义(P<0.05),在放疗结束后两组之间的体质量平均值逐渐接近.单次照射部分3组之间体质量差异无统计学意义(P>0.05).结论:本研究显示,在单次大剂量照射部分和常规照射部分,阿米福汀可以改善大鼠受到照射后引起的肺部症状,改善了照射后肺部肺泡增生和纤维化程度.但是常规照射中连续应用阿米福汀会带来一定的不良反应,在实际应用中造成了大鼠体质量减轻.
揹景與目的:放射性肺損傷是胸部腫瘤放射治療後的常見併髮癥,在放射治療中如何保護肺組織免受或少受放射性損傷顯得非常重要.本研究採用阿米福汀作為放射保護劑,探討其對採用胸壁切線放射治療技術照射大鼠肺組織放射性損傷的保護作用.方法:將35隻雌性Fish-344大白鼠編號後按隨機數字法分為常規照射部分和單次照射部分.常規照射部分:20隻給予照射5週,總劑量為50 Gy,共25次.隨機分為2組,用藥照射組10隻(隨機照射左側、右側各5隻);對照照射組10隻(隨機照射左側、右側各5隻).單次照射部分:15隻右側胸部切線單次照射20 Gy,隨機分為用藥照射組5隻,對照照射組5隻,空白對照組5隻.用藥照射組照射前30 min內腹腔註射阿米福汀(140 mg/kg),對照照射組用相同劑量照射.採用60Co治療機,前後野半野對穿照射.照射結束後記錄呼吸頻率、體質量,尾靜脈取血測轉化生長因子-β1(transforming growth factor-β,TGF-β),取大鼠照射側肺及對照組同側肺進行TGF-β1免疫組織化學染色.結果:常規照射部分用藥照射組在放射後4週呼吸頻率達到最高,對照照射組在放射後2週達到最高,差異有統計學意義(P<0.05).單次照射部分對照照射組升高較用藥照射組差異有統計學意義(P<0.05).常規照射部分及單次照射部分中用藥照射組與單純照射組各段時間內的血清TGF-β1差異無統計學意義(P>0.05).在常規照射部分,肺組織HE染色和馬鬆染色顯示,與正常肺泡壁比較,單純照射組的肺泡壁明顯增厚,其肺泡間質大部分為增生纖維組織和彈力纖維組織.而在照射加藥組雖也有肺泡壁增厚和纖維化,但與單純照射組相比較不甚明顯,可見大部分肺泡結構存在,肺泡壁的纖維化增生較單純照射組減輕.免疫組織化學TGF-β1染色顯示正常組織為陰性或弱暘性的錶達,單純照射組的肺組織TGF-β1染色錶達多為暘性或中彊暘性,照射加藥組錶達為弱暘性或暘性.在常規照射期間,用藥照射組在放療開始後體質量明顯下降,而對照照射組體質量下降不明顯,差異有統計學意義(P<0.05),在放療結束後兩組之間的體質量平均值逐漸接近.單次照射部分3組之間體質量差異無統計學意義(P>0.05).結論:本研究顯示,在單次大劑量照射部分和常規照射部分,阿米福汀可以改善大鼠受到照射後引起的肺部癥狀,改善瞭照射後肺部肺泡增生和纖維化程度.但是常規照射中連續應用阿米福汀會帶來一定的不良反應,在實際應用中造成瞭大鼠體質量減輕.
배경여목적:방사성폐손상시흉부종류방사치료후적상견병발증,재방사치료중여하보호폐조직면수혹소수방사성손상현득비상중요.본연구채용아미복정작위방사보호제,탐토기대채용흉벽절선방사치료기술조사대서폐조직방사성손상적보호작용.방법:장35지자성Fish-344대백서편호후안수궤수자법분위상규조사부분화단차조사부분.상규조사부분:20지급여조사5주,총제량위50 Gy,공25차.수궤분위2조,용약조사조10지(수궤조사좌측、우측각5지);대조조사조10지(수궤조사좌측、우측각5지).단차조사부분:15지우측흉부절선단차조사20 Gy,수궤분위용약조사조5지,대조조사조5지,공백대조조5지.용약조사조조사전30 min내복강주사아미복정(140 mg/kg),대조조사조용상동제량조사.채용60Co치료궤,전후야반야대천조사.조사결속후기록호흡빈솔、체질량,미정맥취혈측전화생장인자-β1(transforming growth factor-β,TGF-β),취대서조사측폐급대조조동측폐진행TGF-β1면역조직화학염색.결과:상규조사부분용약조사조재방사후4주호흡빈솔체도최고,대조조사조재방사후2주체도최고,차이유통계학의의(P<0.05).단차조사부분대조조사조승고교용약조사조차이유통계학의의(P<0.05).상규조사부분급단차조사부분중용약조사조여단순조사조각단시간내적혈청TGF-β1차이무통계학의의(P>0.05).재상규조사부분,폐조직HE염색화마송염색현시,여정상폐포벽비교,단순조사조적폐포벽명현증후,기폐포간질대부분위증생섬유조직화탄력섬유조직.이재조사가약조수야유폐포벽증후화섬유화,단여단순조사조상비교불심명현,가견대부분폐포결구존재,폐포벽적섬유화증생교단순조사조감경.면역조직화학TGF-β1염색현시정상조직위음성혹약양성적표체,단순조사조적폐조직TGF-β1염색표체다위양성혹중강양성,조사가약조표체위약양성혹양성.재상규조사기간,용약조사조재방료개시후체질량명현하강,이대조조사조체질량하강불명현,차이유통계학의의(P<0.05),재방료결속후량조지간적체질량평균치축점접근.단차조사부분3조지간체질량차이무통계학의의(P>0.05).결론:본연구현시,재단차대제량조사부분화상규조사부분,아미복정가이개선대서수도조사후인기적폐부증상,개선료조사후폐부폐포증생화섬유화정도.단시상규조사중련속응용아미복정회대래일정적불량반응,재실제응용중조성료대서체질량감경.
Background and purpose:Radiation-induced lung injury is a common complication in thoracic tumor after radiation therapy. How to protect the lung tissues from radiation injury is very important during radiotherapy. As a kind of radiation-protective agents, this study aimed to assess the protective effects of amifostine on acute lung tissues’ radiation-induced injury in the rats by radiated with chest wall tangent technology. Methods:Thirty-five female Fish-344 rats were randomized into 2 arms of 2 different fraction schedule:Conventional fraction, 20 rats were irradiated in 50 Gy per 25 fractions in 25 days. They were further randomized into 2 subgroups:10 with amifostine and 10 rats radiation alone without drug. Single fraction, 15 rats irradiated with 20 Gy in one fraction to the right lung. Three subgroups were randomized as:5 rats in irradiation plus amifostine;5 rats irradiation alone and 5 in control subgroup. Amifostine (140 mg/kg) was given intraperitoneally 30 minutes before irradiation. Breathing rate, weight variation and plasmas of transforming growth factor-β(TGF-β) 1 levels were recorded after irradiation. The lung tissue of irradiated side and the same side of control group were processed for hematoxylin and eosin staining, Masson’s and Weigen’s staining and TGF-β1 immunohistochemistry staining. Results:In both arms, breathing rate increased in rats got irradiated, however, the coming time of fastest breathing rate delayed in rats with amifostine. There is no difference among all subgroups of TGF-β1 level in the plasma. Hematoxylin and eosin staining and Masson’s and Weigen’s staining revealed alveolar wall became thicker and the pulmonary tissue fibrosis in irradiation alone group. However, in the radiation with amifostine group, no matter what schedule of fractionation, much more of the lung architecture was preserved and fibrosis was lessened. Immunohistochemistry staining was expressed positive to strongly positive in irradiation alone groups, but weakly positive to positive in irradiation with amifostine groups. In arm of conventional fraction group, compared with radiation alone group, weight loss in rats with amifostine used group was much more and had significant difference right after radiation initiated, but became closer when radiation finished. In arm of single fraction group, there was no significant difference of weight loss among 3 groups. Conclusion:This preclinical research showed amifostine can improve radiation-induced pneumonias symptoms, pulmonary alveoli hyperplasia and the pulmonary tissue fibrosis in rats either with conventional or single dose fractionation irradiation. Weight loss in rats with conventional fractionation may related to the side effect of amifostine with continuous apply.
