陈刚,马创,徐万龙,锡林宝勒日,白靖平.不同剂量水平椎体IMRT对比格犬椎体骨细胞的损伤作用[J].中华放射医学与防护杂志,2013,33(4):368-372
不同剂量水平椎体IMRT对比格犬椎体骨细胞的损伤作用
The biological effect of spinal intensity modulated radiation therapy on bone tissue at different doses in Beagles
投稿时间:2013-01-15  
DOI:10.3760/cma.j.issn.0254-5098.2013.04.008
中文关键词:  调强适形放疗  椎体  凋亡  剂量  血管内皮细胞生长因子
英文关键词:Intensity modulated radiation therapy  Spine  Apoptosis  Dose  Vascular endothelial growth factor
基金项目:国家自然科学基金(81060182);新疆维吾尔自治区科技支疆项目(2013911129);新疆维吾尔自治区自然科学基金(2012211B34)
作者单位E-mail
陈刚 830011 乌鲁木齐, 新疆医科大学第一附属医院骨科  
马创 830011 乌鲁木齐, 新疆医科大学第一附属医院骨科  
徐万龙 新疆自治区人民医院关节外科  
锡林宝勒日 新疆医科大学附属肿瘤医院骨与软组织肿瘤科  
白靖平 新疆医科大学附属肿瘤医院骨与软组织肿瘤科 xjbonetumor@126.com 
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中文摘要:
      目的 通过比较不同剂量水平椎体适形调强放疗(IMRT)对成年比格犬椎体骨细胞的损伤作用,初步探讨一次全椎体IMRT的安全剂量范围。方法 选取纯种比格犬30只按随机数字表法平均分为5组,以全椎体IMRT的治疗方式分别对5组比格犬胸9~10椎体给予0、40、50、60和70 Gy剂量的照射,于照后3个月处死,取相同部位的胸9~10节段椎体骨进行HE染色、电镜观察后,免疫组织化学法定量检测椎体中血管内皮细胞生长因子(VEGF)蛋白的表达,TUNEL法定量检测椎体骨中凋亡骨细胞。结果 HE染色结果提示随着IMRT剂量的增大,比格犬椎体骨空骨陷窝率增加明显(F=2.57,P<0.05),骨小梁断裂程度增加,但面积未见明显下降(P> 0.05);电镜结果提示40 Gy IMRT组部分骨细胞出现凋亡,而50 Gy及以上剂量IMRT组绝大多数骨细胞凋亡。TUNEL表达结果提示40 Gy IMRT组骨细胞凋亡率低于50 Gy及以上剂量组骨细胞凋亡率(F=3.52,P<0.05),50 Gy及以上剂量组骨细胞凋亡率差异无统计学意义(P>0.05)。50 Gy以上组的VEGF蛋白表达高于40 Gy组(F=3.64,P<0.05),但50、60、70 Gy组之间差异无统计学意义(P>0.05)。结论 50 Gy可作为临床选择治疗总剂量界限的参考标准。
英文摘要:
      Objective To explore a safe dose range of spinal IMRT by comparing the cell damage in Beagles at different dose levels. Methods Thirty Beagles were randomly divided into 5 groups. The Beagle clinical model of tumor was established in the ninth and tenth thoracic spine. The Beagles were subjected to IMRT with the total doses of 0, 40, 50, 60, 70 Gy, respectively. The samples of spine were taken out from the same locum of the ninth and tenth thoracic spine at 3 month after radiation. All the samples were observed by the hematoxylin-eosin staining, and the VEGF expression in spine was evaluated by immunohistochemistry. Terminal deoxynucleatidyl transferase mediated dUTP nick and labeling (TUNEL) technique was used to examine the apoptotic cells in the spine. Results The osteocytes in the spine showed reversible injury in 40 Gy group, and cell apoptosis in 50, 60, 70 Gy groups. Compared with 40 Gy group,the rates of lacuna were increased in 50, 60, 70 Gy groups(F=2.57, P<0.05),as well as the cell apoptotic rates(F=3.52, P<0.05) and the expression of VEGF (F=3.64, P<0.05), but there were no significant differences among 50, 60, 70 Gy groups (P>0.05). Conclusions The late radiotherapy response of the spine was obviously observed at 3 month after radiation, especially at 50 Gy.
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