乳癌手術後放射線治療對末梢白血球數的影響

EFFECTS OF RADIOTHERARY ON PERIPHERAL WHITE BLOOD CELL COUNTS IN MAMMARY CARCINOMA

陳光耀(Kuang Y. Chen) ； 何佩華(Pey H. Ho) ； 陳麗華(Li H. Chen)

《中華放射線醫學雜誌》 2卷4期 (1977/12) Pp. 311-316

摘要

榮民總醫院癌病治療中心自1972年1月至1976年12月，於手術後以放射線治療96名乳癌病人病側的胸壁和週邊淋巴鏈。所有的病人均有病理診斷證實是乳癌，但手術前後都沒有接受化學治療或激素治療。病人的年齡以41～50最多(33%)，51～60歲次多(25%)。53%的病人會經接受根本乳房切除術，25%接受簡單乳房切除術，19 %接受修飾性根本乳房切除術，其餘病人只接受腫瘤切除。胸壁和周邊淋巴區通常在5～7過內接受5,000～7,000雷得放射線治療。放射線治療至第2週以後，白血球數中值通常下降20-50%，17/96的病人因白血球＜3,000 / cmm 而中斷放射線治療。11 / 17在2週之內白血球囘升而繼續放射治療，但6/17因白血球再次降低而第2次中斷治療，2/6第3次中斷治療，不過全在2週之內恢復照射，最後都能完成治療。有白血球降低傾向的病人似乎與年齡、手術種類和放射線劑量無關，但她們治療前的中值白血球數只有5,600/ cmm，較全體病人治療前白血球數中值7,830 / cmm為低，暗示除了放射線照射骨髓外，乳癌手術後病人白血球降低，或者非放射線因素。

並列摘要

Peripheral white blood cells were counted before and periodically during radiotherapy for 96 patients of carcinoma of breast who had received radical mastectomy or less radical surgery. No adjunct chemotherapy was given. Radiotherapy was interrupted temporarily if white counts dropped to 3,000/cmm or lower, but the treatment would be resumed if white counts recovered back to 4,000/cmm or＞ 3,000/cmm for several times. Generally white count dropped 20-50% during the course of radiotherapy. Seventeen (18%) patients had at least once treatment interruption, 6/17 had the second and 2/6 had the third interruption. Majority of treatments resumed within 2 weeks. The over all median white count was 7,830/cmm, but the inital median white count was only 5,600/cmm for those 17 patients who had treatment interruption . The data suggested that a non-radiation factor of leukopenia might exist in addition to bone marrow irradiation in carcinoma of breast postoperatively.