鼻咽癌患者放疗后口腔干燥的相关因素分析  

Symptomatic Analysis on Xerostomia Induced by Radiotherapy in Patients with Nasopharyngeal Carcinoma

作　　者：白永瑞[1] 姚原[1] 陆冬青[1] 王香果[1] 陈音[1] 吴国华[1] 

机构地区：[1]上海第二医科大学新华医院放疗科,上海200092

出　　处：《上海第二医科大学学报》2003年第B10期88-90,106,共4页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：目的 观察分析鼻咽癌患者放疗后口干变化及其相关因素。方法 74例癌鼻咽癌患者(低分化鳞癌),其中面颈联合野31例,非面颈联合野43例。分别于放疗中、放疗结束和放疗后6、12、24、36月评价患者主观口干程度。结果 随访时间均达3年以上。患者放疗开始后出现口干的中位时间为放疗的第4次;放疗结束时,82％(61/74)患者出现重度口干。放疗后6、12、24、36月,耳前野为主野的照射组口干恢复情况明显好于面颈联合野为主野组(P<0.001)。患者总体放疗后口干程度进行性减轻,2年后相对稳定。结论 鼻咽癌患者常规放射治疗所致口腔干燥随放疗后时间的延长而显著改善。减少腮腺区域受照体积有助于鼻咽癌患者涎腺功能障碍的恢复。Objective Most patients with nasopharyngeal carcinoma would have xerostomia after radical radiation treatment. The purpose of this study is to investigate the trend of xerostomia and its relations with field design and the different time of follow - up. Methods Seventy - four patients histologi-cally proven nasopharyngeal squamous cell carcinoma were eligible to enter into analysis and all the patients had the clinical documents of xerostomia in details. The median age was 52 years old (range; 26-74). Thirty - one patients were irradiated with faciocervical field and 43 patients with pre - ear field. The degree of xerostomia was evaluated for all the patients at the time of radiotherapy, at the end of radiotherapy and 6, 12, 24, 36 months after radiotherapy respectively. Results All the patients were followed up for at least 3 years. The median time of the appearing of xerostomia complained by patients was the fourth fraction of radiotherapy. Eighty -two percent (61/74 cases) of the patients suffered severe xerostomia. For the patients with pre - ear field, the modification degree of xerostomia was significantly better than that with faciocervical field at the time points of 6, 12, 24, 36 months after treatment (P < 0.001). Xerostomia symptom was gradually alleviated as the time of follow - up extended and the recovery seemed to attain to the stable stage of platform after 2 years. Conclusion The degree of xerostomia induced by conventional radiotherapy of the patients with nasopharyngeal carcinoma would significantly decrease as the time of follow - up went by. The more volume of parotid spared from irradiation, the more function of the saliavary would be remained.

关 键 词：鼻咽癌 口腔干燥 相关因素分析 放射治疗 

分 类 号：R739.63[医药卫生—肿瘤]