| Objective: To investigate the effect of thalidomide in the antagonism of acute radiation proctitis in patients of cervical cancer.Methods: Choose patients with stage IIB to IVA of cervical cancer from August 2018 to September 2020 in Shaoyang Central Hospital,diagnosed was confirmed by radiographic imaging and histopathological examination.Patients were randomly assigned by computer-generated codes to thalidomide group(100 mg,orally once a day in the night till radiotherapy ended)or blank control group,in addition to standard radiotherapy as guideline reported.To observe the severity,incidence and risk of ARP,and detect the changes of IL-1β and IL-6 on 0th,20 th day of radiotherapy,and the first day after radiotherapy in both groups.Results:(1)The incidence of grade I and II ARP in thalidomide group was 17.65% and 9.8%,which was respectively lower than that in control group.3 cases of III grade ARP occurred in control group but not in thalidomide group(P<0.05).(2)The risk of radiation proctitis during radiotherapy in control group was higher than that in thalidomide group(P<0.05).(3)The level of serum IL-6 in thalidomide group and control group increased with the prolongation of radiotherapy time,and the rising rate in control group was faster than that in control group.There was significant difference between the two groups at each time point(P<0.01).There was no significant difference in serum IL-6 level between thalidomide group and control group on the 0th day of radiotherapy(P>0.05).On the 20 th day of radiotherapy and the first day after radiotherapy,compared with the control group,the serum IL-6 level decreased by 2.6ng/L and 5.3 ng/L,and the difference was statistically significant(P<0.01).(4)There was no significant difference in serum IL-6 level between thalidomide group and control group on the 0th day of radiotherapy(P>0.05).The serum IL-1β level of thalidomide group on the 20 th day and the first day after radiotherapy,compared with the control group,the serum IL-6 level decreased by 1.3ng/L and 1.88 ng/L(P<0.05).(5)The Serum IL-6 and IL-1β levels in patients with radiation proctitis in the thalidomide group were higher than those in patients without radiation proctitis(P<0.05);(6)There was no significant difference in hematological toxicity related indexes between thalidomide group and control group(P>0.05).(7)The incidence of acute renal injury in the control group was higher than that in the thalidomide group(P<0.05).(8)The incidence of drowsiness in the thalidomide group was higher than control group(P< 0.01).There was no significant difference in the incidence of constipation,rash,neurotoxicity and other adverse reactions between the two groups(P >0.05).Conclusion:(1)Thalidomide is safe and effective in the antagonism of acute radiation proctitis of cervical cancer;(2)To reduce the incidence and severity of acute radiation proctitis which one of reason is thalidomide can inhibit serum IL-6 and IL-1β. |
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