D'iakova A M, Stefani N V, Andreev V G, Senokosov N I, Pavlov V V
Med Radiol (Mosk). 1984 Dec;29(12):49-54.
The use of metronidazole in radiation therapy of laryngeal cancer (SFD = 20 Gy) as a radiosensitizer of tumor hypoxic cells resulted in changes of the liver function tests: a decrease in the cholinesterase activity, a decrease in the level of cholesterol and albumin esters in the blood serum that characterize synthetic liver function. Similar though more noticeable in amounts shifts were marked in stomach cancer patients following preoperative irradiation (SFD = 20 Gy). A slight decrease in AP activity and a decrease in LDH activity below the initial level were simultaneously noted in the latter group as opposed to the group of laryngeal cancer patients. The deviations from the initial level of such liver function indices as bilirubin and total protein level, alanine and asparagine aminotransferase activity did not depend on the incorporation of metronidazole in the radiotherapeutic scheme and developed one way in the intervention and control groups of patients disregarding tumor site. The comparison of shifts of the liver tests in stomach and laryngeal cancer patients in whom tumor site was responsible for the incorporation of the liver in the irradiated zone or for the distance from it, made it possible to regard MZ direct toxic effect and its radiosensitizing effect on the hepatic tissue as causes of the observed deviations.
在喉癌放射治疗(单次分割剂量 = 20 Gy)中使用甲硝唑作为肿瘤乏氧细胞的放射增敏剂,导致肝功能检查出现变化:胆碱酯酶活性降低,血清中胆固醇和白蛋白酯水平降低,这些是合成肝功能的特征指标。在胃癌患者术前照射(单次分割剂量 = 20 Gy)后也出现了类似但程度更明显的变化。与喉癌患者组相比,后一组同时出现碱性磷酸酶(AP)活性略有降低和乳酸脱氢酶(LDH)活性降至初始水平以下的情况。胆红素、总蛋白水平、丙氨酸和天冬氨酸转氨酶活性等肝功能指标与初始水平的偏差并不取决于放疗方案中是否加入甲硝唑,且在干预组和对照组患者中均以相同方式出现,与肿瘤部位无关。比较胃癌和喉癌患者(肿瘤部位决定肝脏是否在照射区域内或与照射区域的距离)肝功能检查的变化情况,可将观察到的偏差归因于甲硝唑对肝组织的直接毒性作用及其放射增敏作用。