颌下腺移位术预防鼻咽癌放疗后口干燥症的长期效果  

Long-term Effect of Submandibular Salivary Gland Transfer on Radiation-Induced Xerostomia in Patients with Nasopharyngeal Carcinoma

作　　者：刘学奎[1] 郭朱明[1] 苏勇[2] 洪明晃[3] 崔念基[2] 曾宗渊[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学肿瘤防治中心头颈科,广州市510060 [2]华南肿瘤学国家重点实验室中山大学肿瘤防治中心放疗科,广州市510060 [3]华南肿瘤学国家重点实验室中山大学肿瘤防治中心鼻咽科,广州市510060

出　　处：《中国肿瘤临床》2009年第24期1384-1387,共4页Chinese Journal of Clinical Oncology

基　　金：广东省自然科学基金资助(编号:07301085)~~

摘　　要：目的:评价颌下腺移位术预防鼻咽癌放疗后口干燥症的长期效果。方法:70例鼻咽癌患者随机分为试验组36例和对照组34例。试验组在行常规放疗前将颌下腺移位至颏下区,放疗时颏下区设置挡块。^(99)Tc核素扫描检测放疗前后颌下腺功能,测定放疗前后唾液分泌量,放疗后60个月进行口干程度问卷调查,统计5年生存率。结果:放疗后60个月:试验组颌下腺摄取、分泌功能均明显较对照组好,两者之间有显著性差异,P值分别为0.000和0.000;试验组和对照组唾液量的平均值分别为1.65g和0.73g(P=0.000);试验组中度至重度口干燥症的发生率亦显著低于对照组(12.9% vs 78.6%,P=0.000);试验组和对照组的5年生存率分别为86.1%和82.4%,两者之间无显著性差异(P=0.67)。结论:颌下腺移位术不影响鼻咽癌远期疗效,预防鼻咽癌放疗后口干燥症的长期效果良好,可改善鼻咽癌患者放疗后的生存质量。Objective： To investigate the long-term effect of submandibular salivary gland transfer on xerostomia induced by radiation in patients with nasopharyngeal carcinoma （NPC）. Methods： A total of 70 eligible patients with NPC were divided into the test group （36 cases） and the control group （34 cases）. In the test group, the submandibular salivary glands were transferred to the submental space before conventional radiotherapy （XRT） and shielded during XRT. Submandibular gland function and salivary fluid before and after radiotherapy, questionnaire of xerostomia at 60 months after XRT, and 5-year survival rate were compared between the two groups. Results： At 5 years after XRT, the trapping and excretion function of submandibular glands were significantly better in the test group （P=0.000 and P=0.000, respectively）. The mean weight of saliva after XRT was greater in the test group than in the control group （1.65gvs.0.73g, P=-0.000）. Incidence of moderate to severe degree of xerostomia was significantly lower in the test group than in the control group （12.9% vs.78.6%, P=-0.000）. No significant difference was found in 5 year survival rate between the two groups （86.1%vs.82.4%, P〉0.05）. Conclusion： Submandibular gland transfer procedure is safe for NPC patients. It can prevent XRT induced xerostomia and improve the quality of life of NPC patients.

关 键 词：鼻咽癌 放射治疗 口干燥症 预防 颌下腺移位 

分 类 号：R739.63[医药卫生—肿瘤]