鼻咽癌调强放疗后放射性口腔黏膜炎发生的危险因素分析  

Risk factors of radiation induced oral mucositis after intensity-modulated radiotherapy for nasopharyngeal carcinoma

作　　者：王鲁 曹咏梅[1] 史金晔 

机构地区：[1]江苏扬州友好医院(扬州大学医学院附属医院),225000

出　　处：《中国中西医结合耳鼻咽喉科杂志》2017年第6期456-459,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨鼻咽癌患者调强放疗后发生放射性口腔黏膜炎的危险因素。方法选取2015年8月~2016年8月在本院接受调强放疗的鼻咽癌患者92例作为研究对象,按照口腔黏膜炎严重程度进行分组,对各组患者的性别、用药情况、口腔pH值等14项指标进行单因素和多因素Logistic回归分析。结果 92例接受调强放疗的鼻咽癌患者放射性口腔黏膜炎的发生率为100%,其中轻度占23.91%(22/92),重度占76.09%(70/92)。单因素分析显示两组患者在吸烟、口腔护理情况、口腔pH、使用抗生素、化疗及使用口腔保护剂方面差异有统计学意义(P<0.05);多因素Logistic回归分析显示吸烟、口腔护理情况、口腔pH、TNM分期、使用抗生素及化疗是影响放射性口腔黏膜炎发生的独立相关因素。结论鼻咽癌患者调强放疗过程中,吸烟史、口腔护理情况差、TNM分期、同步进行化疗及未使用抗生素是重度口腔黏膜炎发生的危险因素,临床应给予重视并采取相应干预措施。Objective To investigate the risk factors of oral mucositis after intensity-modulated radiotherapy （IMRT） for patients with nasopharyngeal carcinoma （NPC）. Methods A total of 92 patients with nasopharyngeal carcinoma who underwent IMRT from August 2015 to August 2016 were selected and grouped according to the severity of oral mucositis. The univariate analysis and multivariate logistic regression analysis were used to analyze 14 indicators of the patients in each group, such as sex, drug use, oral pH, and so on. Results The incidence of oral mucositis in 92 patients with NPC treated with IMRT was 100%, among which mildly cases accounted for 23.91% （22/92） and severe cases accounted for 76.09%（70/92）. Univariate analysis showed that there were significant differences in smoking, oral care, oral pH, antibiotics, chemotherapy and oral protective agents in the two groups （P〈0.05）. Logistic regression analysis showed that smoking, oral care, oral antibiotics, pH, TNM staging and chemotherapy were independent risk factors of radioactive oral mucositis. Conclusion Smoking history, poor oral care, TNM staging, synchronous chemotherapy and without use of antibiotics are risk factors of severe oral mucositis for patients with NPC during IMRT, which need clinical attention and corresponding intervention measures.

关 键 词：鼻咽癌 调强放疗 放射性口腔黏膜炎 危险因素 

分 类 号：R739.63[医药卫生—肿瘤]