口腔湿度检测装置辅助评价鼻咽癌放射治疗腮腺受损程度的研究  

Research on the use of oral humidity detection device to assist in auxiliary evaluating the degree of parotid gland damage during radiotherapy for nasopharyngeal carcinoma

作　　者：陈仁金 石翔翔 庞皓文 CHEN Renjin;SHI Xiangxiang;PANG Haowen(Department of Oncology,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院肿瘤科,泸州646000

出　　处：《实用肿瘤学杂志》2024年第3期192-199,共8页Practical Oncology Journal

基　　金：四川省医学科研课题计划(编号:S21004);古蔺县人民医院-西南医科大学附属医院科技战略合作项目(编号:2022GLXNYDFY05);核医学与分子影像四川省重点实验室开放课题(编号:HYX20002)。

摘　　要：目的探讨自制口腔湿度检测装置辅助评价鼻咽癌放射治疗腮腺受损程度的效力,进而指导医生及时更改放射治疗计划,减少腮腺所受放射剂量,降低放疗口干症的发病率。方法回顾性分析2022年1月1日-2022年12月31日西南医科大学附属医院肿瘤科使用口腔检测装置的60例鼻咽癌患者口腔湿度与腮腺剂量的关系。根据更改放疗计划的方式分为试验组(n=30)和对照组(n=30),试验组患者使用自制口腔湿度检测试验装置检测口腔湿度,口腔相对湿度低于65%的30例患者行CT模拟定位并更改放疗计划,减小腮腺剂量;对照组患者采集口腔湿度但不干预放疗计划,仅放疗中期行CT校位。放疗结束后对患者的平均口腔湿度、腮腺和靶区剂量学参数进行分析。进行问卷随访,评价两组患者生存质量中的口干、味觉减退、张口困难和龋齿的情况。结果试验组较对照组的平均口腔湿度(t=2.938,P<0.05)、双侧腮腺平均剂量D mean(t_(左)=-2.076、t_(右)=-2.094,P<0.05)、双侧腮腺50%体积的剂量D_(50)(t_(左)=-2.123、t_(右)=-2.230,P<0.05)和双侧腮腺剂量的体积百分比V 30(t_(左)=-2.505、t_(右)=-2.491,P<0.05)均明显降低,而靶区剂量学参数比较差异均无统计学意义(P>0.05)。试验组的口干情况、味觉减退情况小于对照组(P<0.05),张口困难和龋齿评分小于对照组,但差异无统计学意义(P>0.05)。结论口腔湿度检测装置能实时检测放疗患者口腔湿度,进而客观评价患者腮腺受射线的影响情况,从而指导医生适时改变放射治疗计划,最大程度减小鼻咽癌放射治疗患者腮腺受损程度,提高鼻咽癌放射治疗患者生活质量。同时,该装置操作简便、耗时短且无损伤,提高了放射治疗技术的有效性和安全性,值得推广。Objective The aim of this study was to explore the effectiveness of self-made oral humidity detection device to assist in evaluating the degree of parotid gland damage in radiotherapy for nasopharyngeal carcinoma,so as to guide doctors to change the radiotherapy plan in time,reduce the radiation dose to parotid gland,and reduce the incidence of xerostomia after radiotherapy.Methods A retrospective analysis was conducted on the relationship between oral humidity and parotid gland dose of radiotherapy in 60 patients with nasopharyngeal carcinoma using oral detection devices in the Department of Oncology of Southwest Medical University Affiliated Hospital from January 1,2022 to December 31,2022.According to the method of changing the radiotherapy plan,patients were divided into experimental group(n=30)and control group(n=30).The patients in the experimental group used a self-made oral humidity detection device to detect oral humidity,when 30 patients with oral relative humidity below 65%underwent CT simulation positioning and changed the radiotherapy plan to reduce the dose of parotid gland;The control group patients collected oral humidity but did not interfere in the radiotherapy plan,and only underwent CT positioning during the mid-term radiotherapy.The average oral humidity,parotid gland,and target area dose parameters of patients were analyzed after radiotherapy.The follow-up questionnaire was conducted to evaluate the life quality of patients in terms of dry mouth,decreased taste,difficulty opening mouth,and dental caries in two groups.Results The average oral humidity(t=2.938,P<0.05),the D mean of average dose of bilateral parotid glands(t_(left)=-2.076,t_(right)=-2.094,P<0.05),the D_(50)for dose of 50%volume of bilateral parotid glands(t_(left)=-2.123,t_(right)=-2.230,P<0.05),and the volume percentage V 30 of bilateral parotid gland dose(t_(left)=-2.505,t_(right)=-2.491,P<0.05)in patients were significantly reduced in the experimental group compared to the control group,while there was no statistically signi

关 键 词：口腔湿度 放射治疗 鼻咽癌 剂量学 腮腺 

分 类 号：R730.55[医药卫生—肿瘤]