摘要
目的 探讨奥沙利铂并不同分割模式照射对大鼠肾上腺近期生物学效应的影响.方法 将150只Wistar大鼠随机分为对照组(A组)、单纯化疗组(B组)、奥沙利铂+常规分割(12 Gy/5次/1周)组(C组)、奥沙利铂+低分割(12 Gy/2次/1周)组(D组)和奥沙利铂+大分割(12 Gy/1次/1周)组(E组).其中C、D、E组先给予腹腔注射奥沙利铂15 mg/kg,后给予6 MV的X线照射,总照射剂量为12Gy.于照射前和完成照射后第3、7、14、30天8:00在深度麻醉下每组处死6只大鼠,测定血皮质醇水平,观察肾上腺组织学改变.结果 B、C、D、E组大鼠照射后第3天血皮质醇分泌增多,肾上腺髓质内毛细血管网出现扩张充血;第7天血皮质醇分泌较前下降,肾上腺皮质体积呈现不同程度缩小;第14天血皮质醇下降至基础水平,肾上腺皮质球状带细胞代偿性增生;第30天血皮质醇分泌轻度上升,肾上腺形态结构恢复.照射后第3天大鼠血皮质醇水平与照射剂量之间存在明显剂量效应关系(F=25.340,P＜0.01).结论 同步放化疗可引起大鼠肾上腺的急性损伤,不同分割方式照射后皮质醇分泌量和肾上腺形态结构发生阶段性的适应性改变,并且与照射剂量有关.
Abstract
Objective To study the influence of oxaliplatin combined with different fractionated radiotherapy (DFR) on recent biological effects of adrenal gland in rats.Methods A total of 150 Wistar rats were randomized to five groups as:group A (control group),group B (simple oxaliplatin chemotherapy),group C (oxaliplatin +convention fraction radiotherapy,12 Gy,5 times a week),group D (oxaliplatin+hypo-fraction irradiation,12 Gy,2 times a week) and group E (oxaliplatin+high-dose fraction,12 Gy,once a week).The rats in groups C,D and E were given intra-peritoneal injection of oxaliplatin (15 mg/kg) first and followed by 6 MV X-ray irradiation,the total radiation dose was 12 Gy.Before and on days 3,7 14 and 30 after irradiation,six rats in each group were sacrificed at 8 o'clock under deep anesthesia.Serum cortical levels were determined,and adrenal histological changes observed.Results Third day after irradiation,cortisol secretion in rats of groups B,C,D and E increased,and dilated congestion in capillary network in the adrenal medulla could be seen;on day 7,the secretion of cortisol declined,compared with the previous,and the volume of adrenal cortex showed different degrees of reduction;on day 14,the blood cortisol decreased to basal level,and compensatory hyperplasia of adrenal cortical band ceils developed;on day 30,blood cortisol secretion mildly elevated,and adrenal morphology recovered.On third day after irradiation,there was a significant dose-effect relationship between blood cortisol levels and irradiation dose (F=25.340,P＜0.01).Conclusion Concurrent chemo-radiotherapy may cause acute adrenal injury in rats,after different fractionated irradiation,periodic and adaptive changes occur in secretion volume of cortisol and adrenal morphology,which is associated with the dose of irradiation.
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