The Effect of Prophylactic TPO Combined with BMS-IMRT to Esophageal Cancer Patients

The goal of this interventional study is to explore the protective effect of prophylactic TPO combined with bone marrow sparing (BMS)-IMRT in patients with esophageal cancer undergoing concurrent chemoradiotherapy. The main purpose is to reduce the incidence of all grades of thrombocytopenia from 35% to less than 10% by the intervention of study. Participants will initiate concurrent chemoradiotherapy within 2 weeks after enrollment,and they will receive subcutaneous injection of recombinant human thrombopoietin (rhTPO) 15000U once a week during the radiotherapy.

Sex

All

Minimum age

18 Years

Maximum age

75 Years

Inclusion Criteria:

* Age greater than 18 years and less than or equal to 75 years
* Histopathologically confirmed esophageal squamous/adenocarcinoma, clinical stage I-IV A (according to the 7th edition of AJCC（American Joint Committee on Cancer） 2010; Concurrent chemoradiotherapy (≥45Gy) was planned (regardless of whether the patient had received induction adjuvant chemotherapy).
* Karnofsky performance status score ≥80 ·;
* Life expectancy \>6 months;
* Meet the following laboratory diagnostic criteria:

Hemoglobin ≥120g/L, white blood cell ≥4.0×109/L, Neutrophil ≥2.0×109/L, platelet ≥100×109/L;

* Participators had not used granulocyte colony-stimulating factor and thrombopoietin within 3 weeks before enrollment.

Exclusion Criteria:

* A history of malignancy at other sites, excluding curable non-melanotic skin cancer and cervical carcinoma in situ;
* Previous radiotherapy to the chest;
* Patients with existing or suspected (thoracolumbar and pelvic) bone marrow or bone metastases, or a history of bone trauma in this region within 4 weeks;
* Allergy to Gadolinium-based contrast agent;
* Patients with active infection, or combined with rheumatic immune disease, long-term chronic infection, acute infection, etc., so that the body is in an inflammatory state; Blood system diseases with hematopoietic dysfunction;

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