鼻咽癌调强放疗后前庭功能损伤的机制研究  

Vestibular function damage mechanisms in nasopharyngeal carcinoma patients after intensity-modulated radiotherapy

作　　者：刘叶[1] 孙殿水[1] 殷进军[2] 夏明[3] 徐英[1] 孙建华[1] 

机构地区：[1]山东大学第二医院肿瘤防治中心,山东济南250033 [2]威海市立医院放疗科,山东威海264200 [3]山东大学第二医院耳鼻咽喉头颈外科,山东济南250033

出　　处：《山东大学耳鼻喉眼学报》2016年第6期14-17,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨鼻咽癌调强放疗后前庭功能损伤的可能机制。方法分析内耳放疗受量和中耳炎与前庭功能损伤的相关性,用ELISA检测患者放疗前后血清IL-6和IL-17水平的变化。结果有38例符合研究标准的患者,内耳的放疗受量与前庭功能损伤明显相关(P<0.05),中耳炎与前庭功能损伤无明显相关性(P>0.05),放疗后血清IL-6和IL-17水平明显升高(P均<0.05),并与前庭功能损伤明显相关(P<0.05)。结论鼻咽癌调强放疗后前庭放疗受量和前庭炎症反应与前庭功能损伤有关,而中耳炎未见对前庭功能损伤有影响。Objective To explore potential mechanisms of vestibular function damage in nasopharyngeal carcinoma （NPC） patients after intensity-modulated radiotherapy （IMRT）. Methods Patients who received radical IMRT for their NPC were recruited. The serum levels of IL-6 and IL-17 were detected with ELISA method. Vestibular evoked myogenic potential （VEMP） tests were used to evaluate vestibular function and correlation analyses were used to analyze the potential mechanisms of vestibular function damage. Results Thirty-eight patients were included. The mean and maximum radiation doses to the inner ears were both significantly associated with abnormal ocular VEMP （oVEMP） and cervical VE/VlP （cVEMP） （P 〈0.05, all）, but the correlations were all mild. There were no significant correlations between otitis media （OM） and abnormal oVEMP and cVEMP （P 〉 0.05 ）. The serum levels of IL-6 and IL-17 in NPC patients both increased and were significantly associated with abnormal oVEIVIP and cVEMP after irradiation （ P 〈 0.05, all）. Conclusion The radiation doses to the inner ears were associated with the incidence of vestibular function damage, but the correlations were mild. OM had no relations with the incidence of vestibular function damage in present study. The inflammatory responses and possible resolution obstacles of inflammation participated in persistent vestibular function damage after irradiation.

关 键 词：鼻咽肿瘤 前庭功能损伤 炎症细胞因子 调强放疗 

分 类 号：R739.2[医药卫生—肿瘤]