鼻咽癌放疗性角膜损伤的跟踪研究

目的:探讨鼻咽癌(NPC)放射治疗眼部并发症。方法:对 213 例 NPC 初程放疗患者进行跟踪观察。放疗前、放疗中及放疗后作视功能(包括远视力、裂隙灯活体显微镜、眼底、自动电脑视野及视诱发电位)检查和角膜荧光素染色。结果:发生角膜损伤 19 例,占 8.9 %(19/213)。I～Ⅱ期6 例,Ⅲ期 8 例,Ⅳ期 5 例。全部发病患者均无角膜刺激症状,放疗后 10mo 内,角膜病变消退,但知觉仍较对侧眼明显减退;20mo 后尚未恢复正常。未发现晶状体混浊的患者。结论:NPC 放疗性角膜损伤与鼻咽癌临床分期及照射剂量无密切关系(P>0.05),可能主要与角膜感觉神经损伤导致眼表疾病密切相关;不排除患者不同个体对辐射的敏感差异性。

A follow-up study on keratopathy in eyes after radiation therapy for nasopharyngeal carcinoma

AIM: To investigate the ocular complication after radiation therapy for nasopharyngeal carcinoma(NPC).METHODS: The authors performed a previous study on keratopathy in 213 NPC patients who received first stage radiation and had at least 10 months of follow-up. These patients were categorized into three groups depending on NPC clinic stages. Rates and proportions of keratopathy occurring in these groups were compared and analyzed with Chi-square Test and Spearman rank correlation coefficient.RESULTS: Radiation keratopathy developed in 19 patients, about 8.9% (19/213). The latency value was 3 to 30days. The effect of NPC clinic stages and radiation did on the development of keratopathy was not statistically significant (P＞0.05).CONCLUSION: The NPC clinic stages and radiation doses plays few effects on the development of keratopathy. It may play a key role that corneal nerves damage induced ocular surface diseases. It can not be excluded that individuals have different sensitivities to radiation.