鼻咽癌序贯加量调强放疗中个体化聚甲基丙烯酸甲酯支架对口腔正常黏膜的保护作用研究  

Protective effect of individualized polymethyl methacrylate stent on normal oral mucosa during sequential intensity modulated radiation therapy for nasopharyngeal carcinoma

作　　者：关玮豪 魏鑫鑫[1] 代文意 GUAN Weihao;WEI Xinxin;DAI Wenyi(Department of Otolaryngology,Nanyang Central Hospital,Nanyang 473000,He’nan,China)

机构地区：[1]南阳市中心医院耳鼻咽喉科,河南南阳473000

出　　处：《癌症进展》2021年第24期2526-2529,2547,共5页Oncology Progress

摘　　要：目的观察鼻咽癌序贯加量调强放疗(IMRT)中个体化聚甲基丙烯酸甲酯(PMMA)支架的使用效果及对口腔正常黏膜的保护作用。方法将60例鼻咽癌患者按治疗方式不同分为对照组和观察组,每组30例。两组均采用序贯加量IMRT,其中对照组患者在IMRT中佩戴简易口塞,观察组患者在IMRT中佩戴个体化PMMA支架。观察两组的疗效和不良反应,比较均匀性指数(HI)、适形指数(CI)、黏膜损伤情况、疼痛评分、味觉评分。结果两组患者治疗有效率、CI、HI水平比较,差异均无统计学意义(P﹥0.05)。在治疗期间,观察组患者软腭、咽后壁、舌尖、舌根黏膜受损情况明显轻于对照组,差异均有统计学意义(P﹤0.01)。治疗过程中观察组患者疼痛评分明显低于对照组,治疗后4周观察组患者味觉评分明显高于对照组,差异均有统计学意义(P﹤0.01)。两组患者血细胞毒性、恶心呕吐、肝功能损伤和唾液腺损伤发生率比较,差异均无统计学意义(P﹥0.05)。结论鼻咽癌序贯加量IMRT中个体化PMMA支架的应用有较好的效果,对患者口腔黏膜损伤小,且对减轻疼痛和保护味觉有良好的作用,具有临床应用价值。Objective To observe the effect of individualized polymethyl methacrylate(PMMA)stents and the pro-tective effect on normal oral mucosa in sequential intensity modulated radiation therapy(IMRT)for nasopharyngeal carci-noma.Method A total of 60 patients with nasopharyngeal carcinoma were divided into the control group and observa-tion group according to different treatment methods,with 30 cases in each group.Sequential IMRT was used in both groups.The patients in the control group wore simple mouth plugs during IMRT,while the patients in the observation group wore individualized PMMA stents during IMRT.The efficacy and adverse events of the two groups were observed,and the homogeneity index(HI),conformity index(CI),mucosal damage,pain score,and taste score were also compared.Result There was no significant difference in the treatment effective rate,CI,and HI levels between the two groups(P>0.05).During the treatment,the mucosal damage of the soft palate,posterior pharyngeal wall,tongue tip,and tongue base in the observation group was significantly lighter than that in the control group,and the difference was statistically signifi-cant(P<0.01).During the treatment,the pain score of the observation group was significantly lower than that of the con-trol group,and the taste score of the observation group was significantly higher than that of the control group at 4 weeks after treatment,the differences were statistical significance(P<0.01).There were no significant differences in the inci-dences of blood cytotoxicity,nausea and vomiting,liver function damage,and salivary gland damage between the two groups(P>0.05).Conclusion The application of individualized PMMA stents in sequential IMRT for nasopharyngeal carcinoma obtains a good effect with little damage to the oral mucosa of patients,and the therapy could achieve a good ef-fect on reducing pain and protecting taste,indicating clinical application value.

关 键 词：鼻咽癌 序贯加量调强放疗 黏膜损伤 疼痛 

分 类 号：R739.6[医药卫生—肿瘤]