| Objective:Lung cancer is one of the highest incidence of malignant tumors in the world,and also the main cause of death of cancer patients,and its onset is insidious,diagnosed when about 50%are in the advanced stage,lost the opportunity of surgical treatment.Bone metastasis often occur in advanced lung cancer,and strontium dichloride(89Src12)is an effective treatment for multiple bone metastases in lung cancer,but it will have some influence on peripheral blood.The purpose of this study aims to evaluate(1)the effect of the first 89Src12 treatment of bone metastasis of lung cancer on peripheral blood of patients,and its relationship with age and gender;(2)With the cumulative increase of treatment dose,the change trend of peripheral blood in patients of lung cancer with bone metastasis;(3)provide theoretical basis for further individualized treatment.Methods:(1)People who received 89Srcl2 treatment diagnosed with lung cancer with bone metastasis from January 2017 to October 2019 in The Third Affiliated hospital of kunming medical university,and the treatment dose was 4mCi.The value of red blood cell(RBC),white blood cell(WBC),hemoglobin(Hb),platelet(PLT)peripheral blood of 89Srcl2 1 week before treatment,1 month after treatment and 3 months after treatment were recorded,statistical analysis was performed on the patient’s age and gender,drawed the histogram of peripheral blood before and after treatment.(2)Collect the patients who have received 89Srcl2 treatment for three times and each treatment dose is 4mCi in The Third Affiliated hospital of kunming medical university from April 2014 to October 2019.Record the change of RBC,WBC,PLT and Hb 1 week before and 1 month after each treatment.Investigate change in peripheral blood at 1 month after each treatment as cumulative does increase.Results:1.The peripheral blood(WBC,RBC,PLT and Hb)of the patients all decreased different degrees 1 month after the first 89Srcl2 treatment,in which the WBC decreased from(6.33±0.25)× 10,/L before the treatment to(5.48±0.19)×109/L,showing a statistically significant difference from that before the treatment(P<0.001).RBC decreased from(4.77±0.7)×1012/L before treatment to(4.67±0.68)×1012/L,which was statistically different from that before treatment(P<0.05).PLT decreased from(210.67±7.20)×109/L before treatment to(189.30±6.51)× 109/L,showing a statistically significant difference from that before the treatment(P<0.001).Three months after treatment,the peripheral blood(WBC,RBC,PLT and Hb)levels of the patients were similar to those before treatment,and the difference was not statistically significant(P>0.05).2.In the study on the relationship between peripheral blood change and patient’s age and gender,the results showed that 1 month after treatment,age was an independent influencing factor for change of PLT(P<0.05).With increasing doses,<57 years old group compared with≥ 57 years old group,the change in PLT is increased.Gender and age had no effect on WBC,RBC and Hb(P>0.05).Three months after treatment,gender and age had no effect on WBC,RBC,Hb and PLT counts.3.With the increase in the number of 89Srcl2 treatment(accumulative dose),the difference of the decrease of WBC and PLT counts were also larger,that is,the decrease of WBC and PLT counts were more obvious with the increase of the accumulative dose of treatment.The WBC decreased by(0.58±0.12)×109/L before and after the first treatment,(0.77±0.10)×109/L before and after the second treatment,and(0.98±0.14)×109/L before and after the third treatment.Moreover,compared with the first treatment and the third treatment,there was a statistically significant difference(P<0.01).RBC decreased by(0.12±0.10)×1012/L before and after the first treatment,(0.17±0.11)×1012/L before and after the second treatment,and(0.27±0.07)×1012/L before and after the third treatment.The decrease level was similar before and after three treatments,and the difference was not statistically significant(P>0.05).PLT decreased by(26.11±2.01)×109/L before and after the first treatment,(22.95±2.92)×109L before and after the second treatment,and(20.16±2.10)×109/L before and after the third treatment.Moreover,compared with the first treatment and the third treatment,there was a statistically significant difference(P<0.05).Hb decreased by 4.11±2.67g/L before and after the first treatment,3.79±2.01g/L before and after the second treatment,and 3.58±3.26g/L before and after the third treatment.The decrease level was similar before and after three treatments,and the difference was not statistically significant(P>0.05).Conclusions:1.After the first 89Src12 treatment,it may cause the reduction of WBC,PLT and RBC in some patients,among which the most significant ones are WBC and PLT,but it does not cause serious hematological reaction,and the peripheral blood of all patients have recovered after 3 months of treatment,suggesting that 89Src12 treatment is a safe treatment.2.89Src12 treatment may lead to slightly myelosuppressive in the early stage,Therefore,regular follow-up and strict monitoring of peripheral blood after treatment are necessary.3.With the increase of the cumulative dose(number of treatment),the patient’s WBC and PLT may be further reduced.Therefore,for the patients who require multiple treatments of 89Srcl2,regular follow-up is necessary,and blood-raising drugs can be given prevention before the treatment to avoid the occurrence of serious thrombocytopenia or leukopenia and other adverse reactions. |
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