鼻咽癌放化疗发生严重放射性口腔黏膜炎的相关因素探讨  

Prospective study of serious oral mucositis risk factors during radiotherapy for patients with nasopharyngeal carcinoma

作　　者：彭露杏[1] 陈甲信[1] 陆合明[1] 黄宝芹[1] 庞强[1] 邓珊[1] 古俊钊[1] 

机构地区：[1]广西壮族自治区人民医院临床肿瘤中心放疗科,南宁530021

出　　处：《中国临床新医学》2015年第11期1041-1046,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨鼻咽癌患者在综合治疗中发生严重放射性口腔黏膜炎的相关因素,寻找相应的早期预防和干预措施,并建立发生严重口腔黏膜炎的预测模型,为临床治疗提供参考。方法对221例鼻咽癌患者的10项临床指标进行单因素分析和多因素COX回归分析,根据COX回归分析结果建立预后指数(PI)方程,并按PI值将患者划分为严重口腔黏膜炎高发组和低发组,比较其口腔黏膜炎发生率的组间差异。结果多因素COX回归分析提示同步放化疗、口腔护理差、采用常规放疗方法是发生严重口腔黏膜炎的高危因素,PI值>0.2201的患者严重口腔黏膜炎发生率高于PI值≤0.2201患者,差异有统计学意义(P<0.01)。结论同步放化疗、口腔护理差、采用常规放疗方法是发生严重口腔黏膜炎的高危因素。PI值能较好地预测严重放射性口腔黏膜炎的发生,为临床进行预防和治疗提供参考。Objective To study the high risk factors of serious oral mucositis caused by radiotherapy for the patients with nasopharyngeal carcinoma（ NPC）, and to seek for the early treatment and prevention of serious oral mu- cositis, and to establish a predictive model of prognostic index（PI） for physicians to give individualized treatment. Methods The clinical factors of 221 NPC patients with oral mucositis were analyzed by univariate analysis and mul- tifactorial COX regression. PI equation was built on basis of the COX regression model. According to PI values, the patients were classified into 2 different risk groups. The incidence rate of serious oral mucositis was compared between the two groups. Results Muhifactorial COX regression showed that chemotherapy, bad oral cavity and conventions radiotherapy were the high risk factors of serious oral mucositis. There was significant difference in the incidence rate of serious oral mucositis between the two groups classified by PI values （P 〈 0.01）. Conclusion Chemotherapy, bad oral cavity and conventions radiotherapy are high risk factors of serious oral mucositis after radiotherapy for NPC. Ear- ly treatment and preventive actions have some preventive effects on it. PI values may be useful in predicting serious o- ral mucositis caused by radiotherapy for NPC and provide the valuable information for physicians to give individualized treatment.

关 键 词：鼻咽癌 放射疗法 口腔黏膜炎 危险因素 COX回归分析 预后指数 

分 类 号：R739.6[医药卫生—肿瘤]