rhEGF防治急性放射性口腔炎的临床疗效观察  

Clinical effect of rhEGF on acute radiation stomatitis

作　　者：冯崇锦[1] 郭俊兵[1] 陈勇[2] 

机构地区：[1]中山大学附属第一医院口腔科,广州510080 [2]中山大学附属肿瘤医院放疗科

出　　处：《中华放射医学与防护杂志》2006年第1期48-49,共2页Chinese Journal of Radiological Medicine and Protection

基　　金：广东省科技计划基金资助项目(2004B34001003)

摘　　要：目的 观察重组人表皮生长因子（rhEGF）对急性放射性口腔炎的预防和治疗作用。方法 90例接受放射治疗的头颈部恶性肿瘤患者随机分为3组：A组：预防性用药组；B组：治疗性用药组；C组：对照组；每组30例。用药组将rhEGF喷于受照射区的口腔黏膜表面，每天3～4次，对照组仅用多贝氏液漱口，每天3～4次。A组用药与放疗同期进行，B组用药待Ⅰ级放射性口腔炎出现后进行。评价3组放射性口腔炎的发生情况及治疗效果。结果 A组73％（22／30）的患者放射性口腔炎出现在放射剂量≥10Gy后，而C组83％（25／30）出现在〈10Gy时，A组和B组的Ⅲ、Ⅳ级放射性口腔炎发生率均低于C组（P〈0．05）。A、B、C组的治疗有效率分别为96％（29／30）、96％（29／30）和37％（11／30）。用药组与对照组的差异有统计学意义（P〈0．01），用药组放射性口腔炎的愈合时间平均≤7d，对照组≥10d。结论 预防性应用rhEGF可推迟急性放射性口腔炎的发生，预防性或治疗性用药均可降低Ⅲ、Ⅳ级放射性口腔炎的发生率，并能促进放射性口腔炎的愈合，值得临床推广。Objective To evaluate the clinical effect of recombinant human epidermal growth factor （rhEGF） on acute radiation stomatitis （ARS）. Methods A total of 90 patients with head and neck malignant tumor going to receive radiotherapy were randomized into 3 groups： prophylactic application group （group A）; therapeutic application group （group B） and the control group（group C）. The irradiated mucous membrane was sprayed with rhEGF at the beginning of radiotherapy in group A and sprayed after grade Ⅰ radiation stomatitis had appeared in group B. Comparison was made with control patients （group C） who received routine oral care with Dobell＇s solution. The rate of ARS and the clinical effect of rhEGF were evaluated. Results The ARS appeared in 73% （22/30） of the patients after irradiated at a dose more than 10 Gy in group A, and appeared in 83% （25/30） of the patients irradiated at a dose less than 10 Gy in group C. In groups A and B, the rates of grades Ⅲ and Ⅳ ARS were obviously lower than those in group C. The average curative time of the rhEGF treatment groups （group A or B） was less than 7 days whereas, that of the control group （group C） was more than 10 days. The total effective rate of the rhEGF treatment groups was significantly higher than that of the control group （ P 〈 0.01 ）. Conclusion Prophylactic application of rhEGF can postpone the development of ARS. rhEGF can reduce the incidence of grades Ⅲ and Ⅳ of ARS and shorten the curative time of ARS by either prophylactic or therapeutic application. Therefore, it should be highly recommended and popularized.

关 键 词：放射性口腔炎 重组人表皮生长因子 治疗 疗效 RHEGF 

分 类 号：R818[医药卫生—放射医学]