个性化PMMA支架对鼻咽癌放疗中口腔黏膜作用  

PROTECTIVE EFFECT OF PERSONALIZED POLYMETHYL METHACRYLATE STENT ON ORAL MUCOSA DURING RADIOTHERAPY FOR NASOPHARYNGEAL CARCINOMA

作　　者：丛薇 王茹[2] 刘晔[2] 徐全臣[1,2] CONG Wei;WANG Ru;LIU Ye;XU Quanchen(Depatment of Oral Madicine,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院口腔内科,山东青岛266003 [2]青岛大学口腔医学院 [3]威海市立医院口腔科

出　　处：《青岛大学学报（医学版）》2021年第1期35-38,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省重点研发计划项目(2018GSF118150)。

摘　　要：目的观察个性化聚甲基丙烯酸甲酯(PMMA)支架在鼻咽癌放疗中对口腔黏膜的保护效果。方法鼻咽癌病人40例,随机分为实验组和对照组,每组20例。在调强放射治疗(IMRT)定位及IMRT过程中实验组佩戴PMMA口腔支架,对照组佩戴高密度泡沫口塞,比较两组均匀性指数、适形指数、舌体不同部位的平均受照剂量(Dmean)、最大受照剂量(Dmax)以及黏膜损伤程度、黏膜疼痛程度、口干、味觉损伤等指标。结果两组均匀性指数和适形指数差异均无显著性(P>0.05);两组舌根部Dmean、Dmax差异无显著性(P>0.05),实验组舌体及舌尖部Dmean、Dmax均明显小于对照组(t=2.835~4.433,P<0.05);实验组软腭、咽后壁、舌根及舌体部黏膜损伤程度均轻于对照组(Z=4.012~5.221,P<0.05),两组上颊、下颊、硬腭、舌尖部黏膜损伤程度差异无显著性(P>0.05);实验组黏膜疼痛程度轻于对照组(χ^2=12.77,P<0.05),口干、味觉损伤程度亦轻于对照组(F=35.227、120.005,P<0.01)。结论个性化PMMA口腔支架在鼻咽癌病人IMRT中对口腔黏膜有显著保护作用。Objective To investigate the protective effect of personalized polymethyl methacrylate(PMMA)stent on oral mucosa during radiotherapy for nasopharyngeal carcinoma.Methods A total of 40 patients with nasopharyngeal carcinoma were randomly divided into experimental group and control group,with 20 patients in each group.During intensity-modulated ra-diation therapy(IMRT)localization and IMRT,the patients in the experimental group wore a PMMA oral stent,while those in the control group wore a high-density foam mouth plug.The two groups were compared in terms of homogeneity index,conformity index,mean dose(Dmean)and maximum dose(Dmax)of different parts of the tongue,degree of mucosal injury and mucosal pain,dry mouth,and taste dysfunction.Results There were no significant differences between the two groups in homogeneity index and conformity index(P>0.05).There were no significant differences in Dmean and Dmax of the root of tongue between the two groups(P>0.05),while compared with the control group,the experimental group had significantly lower Dmean and Dmax of the body of tongue and the tip of tongue(t=2.835-4.433,P<0.05).Compared with the control group,the experimental group had a significantly lower degree of mucosal injury in the soft palate,the posterior pharyngeal wall,the root of tongue,and the body of tongue(Z=4.012-5.221,P<0.05),and there were no significant differences between the two groups in the degree of mucosal injury in the upper buccal region,the lower buccal region,the hard palate,and the tip of tongue(P>0.05).Compared with the control group,the experimental group had significantly lower degrees of mucosal pain(χ^2=12.77,P<0.05),dry mouth(F=35.227,P<0.01),and taste dysfunction(F=120.005,P<0.01).Conclusion Personalized PMMA oral stent has a significant protective effect on oral mucosa during IMRT for patients with nasopharyngeal carcinoma.

关 键 词：支架 鼻咽癌 放射疗法 计算机辅助 

分 类 号：R739.63[医药卫生—肿瘤]