Ivanov S D, Korytova L I, Yamshanov V A, Ilyin N V, Sibirtsev V S
Central Research Institute of Röentgenology and Radiology, St. Petersburg, Russia.
J Exp Clin Cancer Res. 1997 Dec;16(4):413-8.
The investigation goal of the present report is to use the early post-radiation peripheral blood DNA content changes during radiotherapy (RT) of cancer patients for the prognosis of the subsequent leukopenia value. Twenty-three primary patients with II-III stage Hodgkin's disease were treated at the linear accelerator of 15 Mev electrons by usual fractionation to total 40 Gy dose. The blood DNA content was fluorometrically determined by 4', 6-diamidino-2phenylindole before treatment, then 24 hrs after the 1st irradiation dose, in the middle and at the end of RT course. Retrospective analysis of obtained data demonstrated, that the first group of patients, having blood leukocyte levels above 3 x 10(9)/l at the end of RT, revealed an average blood DNA concentration decrease only after the middle of treatment course. The second group of patients, having at the end of RT severe leukopenia, showed an approximately twofold decrease of the DNA concentration after the first irradiation in 62% of cases. The biochemical change was not accompanied by a proportional decrease of the leukocytes amount. The DNA content fall, at the middle and at the end of RT course, was conditioned both by lymphocytes and granulocytes. These changes were not practically interfaced with plasma changes. Thus, a given biochemical criterium may be used as a sensitive index for the prognosis of leukopenia values after the RT beginning. Such a conclusion was confirmed by in vitro test-irradiation of blood specimens of primary patients with Hodgkin's disease. A significant correlation was found between the new index and the level of leukopenia of the patient's blood during post-treatment course.
本报告的研究目的是利用癌症患者放疗（RT）期间放疗后早期外周血DNA含量变化来预测随后的白细胞减少值。23例II - III期霍奇金病的原发性患者在15Mev电子直线加速器上采用常规分割照射，总剂量达40Gy。在治疗前、第一次照射剂量后24小时、放疗疗程中期及末期，用4',6 - 二脒基 - 2 - 苯基吲哚荧光法测定血液DNA含量。对所得数据的回顾性分析表明，第一组患者在放疗末期血白细胞水平高于3×10⁹/L，仅在治疗疗程中期后血液DNA浓度平均下降。第二组患者在放疗末期出现严重白细胞减少，62%的病例在第一次照射后DNA浓度下降约两倍。生化变化并未伴随白细胞数量成比例下降。放疗疗程中期及末期的DNA含量下降是由淋巴细胞和粒细胞共同导致的。这些变化与血浆变化实际上并无关联。因此，给定的生化标准可作为放疗开始后白细胞减少值预后的敏感指标。这一结论在对原发性霍奇金病患者血液标本进行体外照射试验中得到了证实。在治疗后过程中，新指标与患者血液白细胞减少水平之间存在显著相关性。
