沙利度胺防治鼻咽癌放射性口腔黏膜炎的疗效观察  

The efficacy of thalidomide on preventing and treating radiation-induced oral mucositis in nasopharyngeal carcinoma

作　　者：梁雷锋[1] 衷敬华[2] 严浩林[1] 甘媚[1] 林展[1] 朱海生[1] 

机构地区：[1]玉林市第一人民医院肿瘤科,广西省玉林市537000 [2]赣南医学院第一附属医院肿瘤科

出　　处：《中国肿瘤临床》2017年第23期1189-1193,共5页Chinese Journal of Clinical Oncology

摘　　要：目的:观察沙利度胺防治鼻咽癌(nasopharyngeal carcinoma,NPC)放射性口腔黏膜炎(radiation-induced oral mucositis,RIOM)的疗效。方法:2015年5月至2016年8月就诊于玉林市第一人民医院60例NPC患者随机分配进入试验组和观察组。试验组在放射治疗开始口服沙利度胺片,并用生理盐水+庆大霉素+地塞米松混合液漱口,对照组自放疗开始仅用生理盐水+庆大霉素+地塞米松混合液漱口。观察两组RIOM发生时间及程度。结果:试验组RIOM的发生率低于对照组,差异具有统计学意义(P<0.05),试验组3、4级RIOM的发生率低于对照组,差异具有统计学意义(P<0.05)。两组客观缓解率差异无统计学意义(P>0.05);试验组和对照组口腔照射剂量体积在平均剂量、V30、V35、V40、V45、V50、V54方面差异均无统计学意义(P>0.05);试验组和对照组在营养制剂、激素、抗生素使用方面差异均无统计学意义(P>0.05);两组嗜睡、周围神经毒性、血液学毒性、胃肠道反应方面差异均无统计学意义(P>0.05)。结论:沙利度胺可降低NPC的RIOM的发生率及严重程度。Objective：To evaluate the efficacy and safety of thalidomide on preventing and treating radiation-induced oral mucositis（RIOM） in nasopharyngeal carcinoma（NPC）.Methods：A total of 60 patients with NPC were randomly divided into treatment group and control group.The treatment group took thalidomide and gargled with mixture of saline＋gentamycin ＋ dexamethasone when radiotherapy started,and the control group gargled only with mixture of saline ＋ gentamycin ＋ dexamethasone.The time of occurrence and degree of RIOM in both groups were registered at the same time.Results：The incidence of RIOM in treatment group was lower than that in control group（P0.05）.For the incidence of 3 or 4 grade RIOM,the treatment group was also lower than the control group.No statistical difference in terms of objective response rate was found between the two groups（P0.05）.There was no statistically significant difference between the treatment group and the control group in the oral average dose,V30,V35,V40,V45,V50,and V54（P0.05）.There was no statistically significant difference between the treatment group and the control group in the use of nutrition agents,hormones and antibiotics（P0.05）.There was no statistical difference between the groups in the drowsiness,peripheral nerve toxicity,hematologic toxicity and gastrointestinal reaction（P0.05）.Conclusion：Thalidomide can reduce the incidence and severity of RIOM for radiotherapy of patients with NPC,which deserves clinic application.

关 键 词：沙利度胺 放射性口腔黏膜炎 鼻咽癌 

分 类 号：R739.63[医药卫生—肿瘤]