鼻咽癌调强放疗与三维适形放疗口干燥症对比研究.docVIP

鼻咽癌调强放疗与三维适形放疗口干燥症对比研究 　　【摘要】 目的：观察鼻咽癌患者调强放疗（IMRT）和三维适形放疗（3D-CRT）后口干燥症的程度。方法：分析本院初治鼻咽癌患者85例，其中调强放疗组45例，三维适形放疗组40例。按照RTOG/EORTC急性放射损伤分级标准分别于放疗结束时、放疗后3个月和6个月时评价患者口干程度。结果：放疗结束时，IMRT组口干症状多为1、2级，3D-CRT组口干症状多为2、3级，两组比较差异有统计学意义（Z=-6.58，P0.05；Z=-0.1，P0.05），但两组比较差异有统计学意义（Z=-7.9，P0.05）。结论：调强放疗可明显减轻鼻咽癌患者放疗后的口干燥症，能够提高患者与口腔健康相关的生存质量。 　　【关键词】 鼻咽癌； 调强放疗； 三维适形放疗； 口干燥症 　　【Abstract】 Objective：To observe the influence of intensity-modulated radiotherapy（IMRT） and three-dimensional conformal radiotherapy（3D-CRT） on the xerostomia in patients with nasopharyngeal carcinoma.Method：85 patients with primary nasopharyngeal carcinoma（NPC） in our hospital were analyzed.Among them，forty NPC patients without previous radiotherapy underwent 3D-CRT and another forty-five received IMRT.The levels of mouth dryness were evaluated at the end of radiotherapy，3 months and 6 months after radiotherapy according to RTOG/EORTC acute radiation injury grading standards.Result：At the end of radiotherapy，the majority of the IMRT group was level 1 and 2 on xerostomia symptoms，the 3D-CRT group was level 2 and 3，there was a significant difference between two groups（Z=-6.58，P0.05；Z=-0.1，P0.05），but the difference was statistically significant between the IMRT group and 3D-CRT group（Z=-7.9，P0.05）.Conclusion：IMRT in the treatment of patients with nasopharyngeal carcinoma can reduce the xerostomia after radiotherapy and improve the quality of life associated with oral health. 　　【Key words】 Nasopharyngeal carcinoma； Intensity-modulated radiotherapy； Three-dimensional conformal radiotherapy； Xerostomia 　　First-author’s address：The Cancer Center of Guangzhou Medical University，Guangzhou 510095，China 　　doi：10.3969/j.issn.1674-4985.2015.35.045 　　鼻咽癌（nasopharyngeal carcinoma，NPC）是我国华南地区常见恶性肿瘤之一，由于其特殊的生物学特性及发生部位解剖结构复杂，放射治疗一直被作为首选的治疗方案[1]。唾液腺由于受到照射后其功能受损，大部分患者在放疗中及放疗后会出现口腔干燥症状[2]。唾液量的减少使口腔自洁作用受到影响，易导致龋齿的发生，同时也影响患者的进食及言语。调强放射治疗（IMRT）是放射技术、放射物、医学影像和计算机技术紧密结合的一种全新照射技术，目前临床已广泛采用，它可提高肿瘤局部控制率，并降低周围正常组织受量，减少放射并发症，优势比三维适形放疗更为明