重组人白介素11联合传统含漱液防治鼻咽癌放射性口腔黏膜炎的疗效观察

目的：探讨重组人白介素11(rhIL-11)联合传统含漱液在鼻咽癌放射性口腔黏膜炎防治中的应用效果。方法将2011年8月至2015年12月在广西医科大学第三附属医院肿瘤科确诊的150例鼻咽癌(中国2008分期Ⅲ~Ⅳa期)患者采用随机数表法分为观察组和对照组，每组75例。所有患者采用调强放疗联合奈达铂同步化疗。观察组应用rhIL-11与传统含漱液(碳酸氢钠、利多卡因、地塞米松混合液)交替含漱，对照组仅用传统含漱液单纯含漱，含漱从放疗开始至放疗结束。放疗过程中每天记录两组患者放射性口腔黏膜炎的分级。结果Ⅰ~Ⅳ级放射性口腔黏膜炎发生率观察组分别为6.8%、50.0%、37.8%、5.4%，对照组分别为1.4%、32.4%、54.9%、11.3%，观察组严重(Ⅲ、Ⅳ级)放射性口腔黏膜炎发生率明显低于对照组，差异均有统计学意义(P<0.05)。Ⅰ~Ⅳ级放射性口腔黏膜炎出现时间观察组分别在放疗（13.2±8.1) d、(22.2±7.1) d、(28.2±4.7) d、(34.6±2.1) d，对照组分别在放疗(10.2±8.3) d、(16.5±7.6) d、(20.9±4.3) d、(28.7±2.6) d，随着放疗时间延长，放射性口腔黏膜炎逐渐加重，观察组各级放射性口腔黏膜炎出现的时间均比对照组晚，差异均有统计学意义(P<0.05)。Ⅰ~Ⅳ级放射性口腔黏膜炎持续时间观察组分别为(23.2±8.3) d、(15.2±5.1) d、(10.7±4.8) d、(5.2±2.3) d，对照组分别为(18.2±8.6) d、(21.5±6.0) d、(15.9±6.3) d、(7.2±2.6) d，严重放射性口腔黏膜炎(Ⅲ、Ⅳ级)持续时间观察组均比对照组短，差异均有统计学意义(P<0.05)。结论 rhIL-11联合传统含漱液能明显降低鼻咽癌严重放射性口腔黏膜炎发生率，推迟放射性口腔黏膜炎的发生时间，缩短严重放射性口腔黏膜炎持续时间，在鼻咽癌放射性口腔黏膜炎防治中起到明显的作用。

Efficacy of recombinant human interleukin 11 and traditional mouthwash in prevention and treatment of radiation-induced oral mucositis in patients with nasopharyngeal carcinoma

Objective To study the role of recombinant human interleukin 11 (rhIL-11) and traditional mouth-wash in prevention and treatment of radiation-induced oral mucositis in patients with nasopharyngeal carcinoma (NPC). Methods One hundred and fifty patients with stageⅢ-Ⅳa NPC (Chinese 2008 Staging System) were randomly divid-ed into study group (n=75) and control group (n=75) by random number table, who were diagnosed in the Department of Oncology of the Third Affiliated Hospital of Guangxi Medical University from August 2011 to December 2015. All pa-tients received intensity-modulated radiotherapy and nedaplatinum chemotherapy. From the beginning to the end of ra-diotherapy, the study group applied rhIL-11 and traditional mouthwash (sodium bicarbonate, lidocaine and dexametha-sone mixture) to gargle alternately, and the control group used traditional mouthwash only. The classification of radia-tion-induced oral mucositis in the process of radiotherapy was recorded every day. Results The incidence of stageⅠ-Ⅳradiation-induced oral mucositis in the study group were 6.8%, 50.0%, 37.8%, 5.4%, respectively, which in the con-trol group were 1.4%, 32.4%, 54.9%, 11.3%respectively. The incidence of serious radiation-induced oral mucositis (Ⅲ,Ⅳ) were significantly lower in the study group than the control group (P<0.05). In the study group, the time of stageⅠ-Ⅳradiation-induced oral mucositis were in the radiation of (13.2±8.1) d, (22.2±7.1) d, (28.2±4.7) d, (34.6±2.1) d, which were in the radiation of (10.2±8.3) d, (16.5±7.6) d, (20.9±4.3) d, (28.7±2.6) d in the control group. As the radiotherapy time extended, radiation-induced oral mucositis aggravated gradually, and the time of all stages of radiation-induced oral mucositis in study group was significantly later than that in control group (P<0.05). In the study group, the duration of stageⅠ-Ⅳradiation-induced oral mucositis were (23.2±8.3) d, (15.2±5.1) d, (10.7±4.8) d, (5.2±2.3) d, which in the con-trol group were (18.2±8.6) d, (21.5±6.0) d, (15.9±6.3) d, (7.2±2.6) d. The duration of serious oral mucositis (Ⅲ,Ⅳ) in the study group were significantly shorter than that in the control group (P<0.05). Conclusion rhIL-11 combined with tradition-al mouthwash could significantly reduce the incidence of serious radiation-induced oral mucositis in patients with NPC, delay the occurrence of radiation-induced oral mucositis, and shorten the duration of severe radiation-induced oral mucositis, which plays a significant role in prevention and treatment of radiation-induced oral mucositis in patients with NPC.