鼻咽癌调强放疗对口干症状的影响

目的观察调强放射治疗(IMRT)对鼻咽癌患者口干症状的影响。方法 82例初治鼻咽癌患者分为调强组43例和常规组39例,分别进行IMRT和常规放疗,其中鼻咽大体肿瘤体积(GTVnx)的处方剂量分别为68Gy和68～72Gy。在放疗前、放疗结束时、放疗后3个月时行放射性核素显像以检测腮腺99mTc清除率测定其摄取指数(UI)和分泌指数(EI),并按RTOG/EORTC急性放射损伤分级标准评价患者口干程度。结果放疗结束时调强组口干症状多为1、2级,而常规组口干症状多为2、3级,两组有显著差异(P<0.001)。在放疗后3个月中,调强组口干症状明显改善,而常规组口干症状无明显好转。放疗结束时及放疗后3个月两组腮腺分泌指数(EI)有显著差异(P<0.01),而各时间点摄取指数(U)无显著差异(P>0.05)。结论鼻咽癌IMRT在确保肿瘤高剂量的同时,保护了腮腺功能,减轻口干症状,提高了患者的生存质量。

The Influence on the Xerostomia after IMRT in Nasopharyngeal Cancer

Objective To observe the influence of intensity modulated radiation therapy (IMRT) on the xerostomia in patients with nasophargeal cancer. Methods 82 patients with primary nasopharyngeal cancer were divided into two groups: IMRT group (43 cases) treated with IMRT (GTVnx 70 Gy/28 fx) and conventional radiotheraphy group (39 cases) treated with conventional radiotheraphy (GTVnx 70 Gy/35 fx) to the tumor regions. The level of mouth dryness and the parotid function were compared before treatment, after treatment and 3 months after treatment. Results According to the xerostomia symptom, there were 7 cases of grade 3 in IMRT group, 22 cases of grade 3 in conventional radiotherapy group. The result had significant difference (P<0.001). After 3 months of follow up, the xerostomia improved in IMRT group however not in another group. There was significant difference in EI after radiotherapy (P<0.001) but no significance in every time (P>0.05). Conclusions Using intensity-modulated radiotherapy to treat the patient with nasopharyngeal cancer can secure the high dose in tumor regions, protecet the parotid function evidently and reduce the xerostomia, which can improve the life quality of patients.