黄芩中酚性苷类对腮腺放射损伤的防护作用的研究

目的：研究黄芩中酚性苷类对鼻咽癌患者腮腺放射损伤的防护作用。方法：从2000年4月-2001年3月将85例鼻咽癌随机分为两组：单纯放疗组(对照组)和放疗加黄芩酚性苷类组(实验组)，分别在放疗前和两侧对穿野放疗至60Gy时以^99m锝核素扫描检测腮腺的摄取和排泌功能，同时每周观察患者的口干症状和口腔黏膜反应。结果：急性口腔黏膜反应的分级两组间差异无显著意义，P=0．341；两组口干程度差异比较也无显著意义，P=0．079。放疗前后双侧腮腺摄取和排泌功能下降程度的比较两组间差异均无显著意义，P=0．521和0．572。结论：黄芩中酚性苷类对接受两侧对穿野放疗达60Gy鼻咽癌患者的腮腺未能显示出放射防护作用。     

黄芩中酚性苷类对腮腺放射损伤的防护作用的研究

目的 :研究黄芩中酚性苷类对鼻咽癌患者腮腺放射损伤的防护作用。方法 :从 2 0 0 0年 4月 -2 0 0 1年 3月将 85例鼻咽癌随机分为两组 :单纯放疗组 (对照组 )和放疗加黄芩酚性苷类组 (实验组 ) ,分别在放疗前和两侧对穿野放疗至 6 0Gy时以 99m锝核素扫描检测腮腺的摄取和排泌功能 ,同时每周观察患者的口干症状和口腔黏膜反应。结果 :急性口腔黏膜反应的分级两组间差异无显著意义 ,P =0 341;两组口干程度差异比较也无显著意义 ,P =0 0 79。放疗前后双侧腮腺摄取和排泌功能下降程度的比较两组间差异均无显著意义 ,P =0 5 2 1和 0 5 72。结论 :黄芩中酚性苷类对接受两侧对穿野放疗达 6 0Gy鼻咽癌患者的腮腺未能显示出放射防护作用     

唾液腺放射性损伤及其防护

放射治疗在头颈肿瘤的地位已得到广泛认同,但放疗并发症不容忽视,最常见的是放射性口干。其主要机制为放射诱导的唾液腺损伤,早期和晚期损伤的机制不同。目前对唾液腺放射防护的研究主要集中在放射防护剂、放射技术、基因转移技术等多个方面。     

唾液腺放射性损伤及其防护

放射治疗在头颈肿瘤的地位已得到广泛认同,但放疗并发症不容忽视,最常见的是放射性口干。其主要机制为放射诱导的唾液腺损伤,早期和晚期损伤的机制不同。目前对唾液腺放射防护的研究主要集中在放射防护剂、放射技术、基因转移技术等多个方面。     

鼻咽癌调强放疗等效均匀剂量优化方法对腮腺的保护作用

目的 探索等效均匀剂量（EUD）优化方法在鼻咽癌调强放疗中对腮腺的保护作用。方法 从已接受调强放疗的鼻咽癌患者中，随机抽取12例。这些患者的治疗计划均是采用物理约束条件优化设计的。以这些计划为基础，将腮腺的物理约束条件改为EUD约束，而保持其他危及器官和靶区的约束条件不变，为每位患者设计一个新的计划，并比较新旧治疗计划。结果 在保证靶区和其他危及器官受照剂量不变情况下，EUD优化能够使腮腺的平均剂量和V30显著降低，经T检验，P值都〈0．05。结论 EUD优化能够降低腮腺的受照剂量，这对降低腮腺放疗并发症具有重要意义，也为靶区加量提供了空间。     

比亚芬预防鼻咽癌放射性皮肤损伤的临床观察

目的观察比亚芬乳膏防治鼻咽癌同期放化疗患者急性放射性皮肤损伤的临床疗效。方法 6MV-X线三维适形技术照射,并联合顺铂同步化疗。结果 用药组23例在第1次放射治疗及化疗后给予比亚芬乳膏涂抹;对照组24例只做常规放射治疗宣教和健康教育。两组患者皮肤反应发生率为100%。轻度放射反应(1+2度):用药组为87.0%(20/23例),对照组为45.8%(15/24例),3度放射反应:用药组8.7%(2/23例),对照组45.8%(11/24例),两组之间有显著差异(P＜0.01)。皮肤反应发生剂量:用药组30.4%(7/23例)、对照组95.8%(23/24例),出现于照射40Gy以前。结论 比亚芬能有效地预防鼻咽癌同期放化疗较严重放射性皮炎的发生,保证放射治疗的顺利进行。     

肿节风颗粒对小型猪腮腺放射防护作用的研究

目的:观察肿节风颗粒对小型猪腮腺照射后活性氧簇(reactive oxygen species,ROS)的清除作用。方法:60只小型猪随机分成空白对照组(对照组)、单纯照射组(单照组)和肿节风加照射组(药照组)3组,每组20只;每组平行分成a、b、c和d 4个亚组,每组5只,分别于照射结束后1、10、40和90d取腮腺组织,药照组于照射前1周开始给予肿节风颗粒(0.3g/kg),直至腮腺组织取出,对照组与单照组给予等量生理盐水。在全麻状态下肿节风组跟单照组给予60 C0γ射线双侧腮腺照射,30Gy/(5f.5w),对照组不予照射,观察各组腮腺质量及ROS含量变化。结果:照射后1d,对照组、单照组、药照组ROS含量分别为(62.58±8.96)、(136.75±33.78)和(62.83±35.25)U/mL,对照组与药照组差异无统计学意义,P>0.01;单照组与药照组和对照组之间差异有统计学意义,P<0.01;照射后10d,对照组、单照组、药照组ROS含量分别为(64.50±8.40)、(338.50±30.36)和(281.67±48.72)U/mL,三组之间差异均有统计学意义,P<0.01;照射后40d,对照组、单照组、药照组ROS含量分别为(62.92±6.34)、(392.83±32.66)和(324.42±54.57)U/mL,三组之间差异均有统计学意义,P<0.01;照射后90d,对照组、单照组、药照组ROS含量分别为(62.75±7.01)、(438.92±36.31)和(323.75±49.30)U/mL,三组之间差异均有统计学意义,P<0.01;药照组的ROS含量均低于单照组。结论:肿节风通过清除小型猪腮腺放射后的ROS活性,能有效减缓腮腺放射损伤。     

比亚芬预防放射性皮肤损伤的疗效观察

目的　观察比亚芬乳膏预防急性放射性皮肤损伤的临床疗效。方法　将 10 4例需要放射治疗的患者随机分为 2个组 ,5 6例在第 1次放射治疗后给予比亚芬涂抹为用药组 ,4 8例只做常规放射治疗宣教和健康教育为对照组。结果　皮肤反应发生率对照组和用药组分别为 93.8%、30 .4 %。轻度放射反应 ( 1 2级 )对照组为 6 6 .7% ( 32 / 4 8) ,用药组为 2 8.6 % ( 16 / 5 6 )。皮肤反应发生剂量对照组 91.1% ( 4 1/ 4 5 )出现于照射 4 0Gy以前 ,用药组为 2 9.4 % ( 5 / 17)。结论　比亚芬能有效地预防放射性皮炎的发生 ,对患者能减轻痛苦、提高生活质量、保证放射治疗的顺利进行     

三乙醇胺乳膏预防急性放射性皮肤损伤的临床观察

[目的]观察三乙醇胺乳膏预防急性放射性皮肤损伤的临床疗效。[方法]将127例行放射治疗的患者随机分为两组,用药组67例在第1次放疗后及每次放疗前2～3h给予三乙醇胺乳膏涂抹,对照组60例只做常规护理宣教和健康教育。[结果]用药组和对照组皮肤反应发生率分别为70.2%（47/67）、100%（60/60）。0＋Ⅰ＋Ⅱ级皮肤反应发生率用药组为94.03%（63/67）,对照组为70%（42/60）（P〈0.05）。皮肤反应发生剂量对照组90%（54/60）出现于照射40Gy以前,用药组仅为21.28%（10/47）（P〈0.05）。[结论]三乙醇胺乳膏能有效预防急性放射性皮肤损伤的发生,提高皮肤耐受性,使放疗反应出现晚、程度低,保证放射治疗的顺利进行。     

改良腮腺切除术与传统腮腺切除术对腮腺肿瘤的疗效对比

目的 比较改良腮腺切除术与传统腮腺切除术对腮腺肿瘤的治疗效果.方法 收取腮腺肿瘤患者80例作为研究对象,按照手术方式的不同划分为观察组与对照组.观察组43例,行改良腮腺切除术;对照组37例,行传统腮腺切除术.对两组患者围手术期情况、并发症发生情况以及术后生活质量恢复情况进行对比.结果 观察组患者住院时间明显短于对照组,差异具有统计学意义(P＜0.05),其他围手术期指标两组差异不显著.观察组术后并发症发生率(13.95％)明显低于对照组(45.95％),差异有统计学意义(P＜0.05).观察组肿瘤复发率为2.33％,对照组为5.41％,两组相较无显著差异(P＞0.05).观察组患者生活质量恢复有效率为88.37％,对照组为83.78％,两组相比差异无统计学意义.但观察组生活质量改善率为60.47％,远高于对照组(24.32％),差异有统计学意义.结论 改良腮腺切除术对于腮腺肿瘤具有良好的临床疗效,且安全性高,对于患者生活质量改善具有积极的意义,值得临床推广应用.     

腮腺皮脂腺癌：附6例报告

本文报告6例罕见的腮腺皮脂腺癌临床及病理特征。用粘液染色方法及形态学表现来区别其它唾腺恶性肿瘤,确定了诊断标准,讨论了组织来源,认为其来自组织化生。该肿瘤属于低度恶性,因放疗及化疗均不敏感,局部广泛切除为最佳疗法。     

Parotid gland metastasis of a breast cancer

Abstract Parotid gland metastases from malignant tumors are extremely rare. A 61-year-old woman was diagnosed with an early breast cancer with no expression of oestrogen and progesterone receptors. Five years later the patient presented a tumour in parotid gland. After total parotidectomy, microscopic analysis of the gland demonstrated an invasive duct carcinoma (IDC) with positive expression of oestrogen receptor. The patient was treated with chemotherapy followed by complementary local radiotherapy. Diagnosis of a metastasic tumour in parotid gland poses a challenge. In our case an immunohistochemical study of oestrogen receptor was fundamental to establish a diagnosis.     

Basal Cell Adenoma of Parotid Gland: Case Report and Review of Literature

Basal cell adenoma (BCA) of the salivary gland is a rare neoplasm consists of a monomorphic population of basaloid epithelial cells, and it accounts for approximately 1–2 % of all salivary gland tumors. Its most frequent location is the parotid gland. It usually appears as a firm and mobile slow-growing mass. Histologically, isomorphic cells in nests and interlaced trabecules with a prominent basal membrane are observed. In contrast to pleomorphic adenoma, it tends to be multiple and its recurrence rate after surgical excision is high. Due to prognostic implications, differential diagnosis with basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma is mandatory. We report a case of BCA of the parotid gland. We also review the literature and discuss the diagnosis and management of this rare entity.     

Interventional Sialendoscopy for Parotid Ductal Calculi: Our Preliminary Experience

With this article we present our initial experience with interventional sialendoscopy of the parotid duct for the parotid calculi. We carried out a prospective study of patients of parotid calculi in a tertiary referral centre. Diagnostic and interventional sialendoscopy was performed in five cases of parotid calculi. The outcome was classified on the basis of clearance of the lumen of the duct and resolution of symptoms. Diagnostic sialendoscopy was able to diagnose the calculus in all cases. Interventional sialendoscopy was done under general anesthesia in all cases and calculus was successfully removed. The average size of sialolith was 8.2 mm. No complications occurred in any of the cases. Check sialendoscopy was done in all cases after a minimum follow up of 6 months, which showed the duct lumen to be free of stone with no stricture of the duct. Sialendoscopy is an optimal technique for removal of intraductal parotid calculi and avoids removal of the gland. In our series there was no associated morbidity and complication.     

Value of Fine-Needle Aspiration Cytology in the Evaluation of Parotid Tumors

Fine needle aspiration cytology (FNAC) is commonly used in the study of parotid masses; however controversy exists regarding its diagnostic accuracy. The objective of this study was to evaluate the effectiveness of FNAC as a preoperative diagnostic tool of parotid tumors. Sixty-five patients had satisfactory preoperative FNAC and underwent subsequent surgery to the parotid between March 2002 and July 2009 at our institution. The results of the FNAC were compared to the permanent histopathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and the overall accuracy of FNAC for parotid masses were 57.9, 97.8, 91.7, 84.9, and 86%, respectively. FNAC is useful in the preoperative assessment of parotid tumors and surgical planning. The non-diagnostic and false-negative results are the limitations of FNAC that should be reduced to improve its usefulness in the evaluation of parotid tumors.     

Parotid gland as a risk organ in whole brain radiotherapy

Background and purpose

Since the introduction of CT-based simulation for use in whole brain radiotherapy (WBRT), we have observed that a large volume of the parotid glands is included in the radiation fields. The purpose of this study is to analyze the dose-volume statistics of the parotid glands in patients undergoing WBRT.

Materials and methods

Thirty-two patients received WBRT using CT-based simulation with bilateral two-field arrangement. Daily fraction was 3 Gy with total dose of 30 Gy in 2 weeks. We analyzed the radiation dose from WBRT to the parotid glands.

Results

Average of the mean parotid dose was 17.5 Gy (range, 10.5-26.2) for both glands. Mean parotid doses ?20 and ?25 Gy were observed in 22 (34.4%) and 4 (6.3%) of 64 individual glands. The numbers of patients with a mean parotid dose of both glands ?20 Gy and ?25 Gy were 12 (37.5%) and 1 (3.1%), respectively.

Conclusions

Mean parotid dose was variable in patients with WBRT. According to the parotid dose and combined potential risk factors, parotid glands can be regarded as a risk organ in WBRT for improvement of patient quality of life.     

头颈部肿瘤放疗对腮腺影响的相关研究

头颈部肿瘤患者放疗过程中,部分腮腺不可避免地被包在计划靶体积(PTV)中,使得此部分腮腺接受与PTV同样剂量的照射.在放疗过程中由于受患者年龄、初始腮腺体积、接受10～ 40 Gy剂量照射的腮腺体积(V10-40)、患者体重、体厚及腮腺平均受照剂量等的影响使得放疗中腮腺体积最多可缩小至原体积的50％左右,并向体中线处移动,结果腮腺所受实际照射剂量高于处方剂量,造成腮腺分泌功能降低,发生严重口腔干燥症,大大影响患者日后生活质量.