Clinical Observation Of Low Dose Thalidomide In The Prevention Of Acute Radiation Enteritis Caused By Radiotherapy For Cervical Cancer

Background and Objectives:With the development and popularization of radiotherapy technology,more and more malignant tumor patients receive radiotherapy,so radiotherapy related complications are becoming more and more common.Acute radiation enteritis is one of the most common complications of radiotherapy for pelvic malignant tumors.Once acute radiation enteritis occurs,it will directly affect the patient's treatment tolerance and ultimately affect the therapeutic effect.At present,there is no unified standard plan for the prevention and treatment of acute radiation enteritis,and many clinical symptoms are given after symptomatic treatment,such as antidiarrheal,analgesic,nutritional support and so on.Therefore,the prevention and treatment of acute radiation enteritis has become a hot topic both at home and abroad.The aim of this study was to observe the clinical efficacy and side effects of low-dose thalidomide in preventing acute radiation enteritis caused by radiotherapy for cervical cancer.Methods:The pathological diagnosis of squamous cell carcinoma of the IIB~IVA stage(FIGO stage)in patients with cervical cancer were randomly divided into experimental group and control group,randomly divided into two groups:1-100random number sequence using the Excel 2013 software,and then according to the order of patients,in order to once used after random sequence number.The odd numbered group entered the test group,and the even numbered group entered the control group.The two groups were treated with concurrent chemoradiotherapy,that is,IMRT+post loading treatment and concurrent chemotherapy with DLF during the course of radiotherapy,and repeated every 3 weeks.The experimental group began to take oral thalidomide 50mg every night before the day of the radiotherapy until the end of the radiotherapy.The incidence and severity of ARE,the occurrence time of ARE,the interruption of radiotherapy,the nausea and vomiting during chemotherapy and the adverse reactions in the two groups during February and after radiotherapy were observed.Results:From January 2016 to August 2017,a total of 71 patients were enrolled.69patients completed the standard treatment,including 34 cases in the trial group and 35cases in the control group.The incidence of acute radiation enteritis at I and II levels in the experimental group was significantly lower than that of the control group(29.41%vs 62.86%,?~2=7.757,P=0.005),and the occurrenc e time of acute radiation enteritis was later than that of the control group(24.00±4.16 days vs 16.59±5.34days,t=3.872,P=0.001).After the end of radiotherapy,the incidence of I and II grade ARE in the experimental group and the control group in February were 8.82%and14.29%,respectively,and there was no significant difference between the two groups(P>0.05).The III or IV grade ARE was not observed in the two groups,and interruption of radiotherapy was not observed.Sleep,appetite and the symptoms of delayed nausea and vomiting induced by chemotherapy were improved in the experimental group.The most common adverse reactions were leukocyte reduction,constipation,fatigue and drowsiness,with no serious adverse reactions observed.Conclusion:Small dose of thalidomide can prevent the occurrence of I and II acute radiation enteritis caused by radiotherapy of cervical cancer,delay its occurrence time,and reduce the incidence of delayed nausea and vomiting related to chemotherapy,with light side effects and good safety.