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磁共振涎管成像评价早期鼻咽癌放疗前后涎腺影像变化与口干关系初探
引用本文:欧丹,张云燕,何霞云,顾雅佳,胡超苏,应红梅,朱国培,吴永如,毛健,沈茜刚,岳磊.磁共振涎管成像评价早期鼻咽癌放疗前后涎腺影像变化与口干关系初探[J].中华放射肿瘤学杂志,2011,20(6).
作者姓名:欧丹  张云燕  何霞云  顾雅佳  胡超苏  应红梅  朱国培  吴永如  毛健  沈茜刚  岳磊
作者单位:1. 复旦大学上海医学院肿瘤学系 复旦大学附属肿瘤医院放疗科, 上海,200032
2. 复旦大学上海医学院肿瘤学系 复旦大学附属肿瘤医院放射诊断科, 上海,200032
基金项目:上海市科学技术委员会“科技创新行动计划”资助项目
摘    要:目的 探索磁共振涎管成像(MRS)评价鼻咽癌放疗前后涎腺影像变化的可行性,及其与患者主观评价的相关性.方法 放疗前、后患者分别行MRS,应用MRS评分系统对患者放疗前、后酸刺激前后涎腺导管进行评分,并结合美国放疗肿瘤组织急性放射损伤标准和欧洲癌症研究与治疗组织QLQ-C30v3.0和QLQ-H&N35量表进行分析.结果 共10例患者进入研究.所有患者双侧腮腺平均受照剂量为(37.99 ±3.70) Gy,双侧颌下腺平均受照剂量为(55.65±2.99) Gy.MRS图像显示酸刺激使涎腺导管评分升高,放疗后导管评分下降,对酸刺激反应较放疗前差.放疗后酸刺激前后腮腺导管评分差值与QLQ-C30量表的总生活质量领域得分呈正相关性(rs=0.636,P=0.048),与QLQ-H&N35量表中的口干条目得分呈负相关性(rs=-0.694,P=0.026).结论 MRS可无创检测涎腺放疗前后影像变化,用来评价鼻咽癌患者放疗后早期口干严重程度有一定的临床参考价值.

关 键 词:磁共振涎管成像  放射性口腔干燥  鼻咽肿瘤/放射疗法

The role of Magnetic resonance sialography in evaluating radiation-induced xerostomia for patients with early stage nasopharyngeal carcinoma
OU Dan,ZHANG Yun-yan,HE Xia-yun,GU Ya-jia,HU Chao-su,YING Hong-mei,ZHU Guo-pei,WU Yong-ru,MAO Jian,SHEN Xi-gang,YUE Lei.The role of Magnetic resonance sialography in evaluating radiation-induced xerostomia for patients with early stage nasopharyngeal carcinoma[J].Chinese Journal of Radiation Oncology,2011,20(6).
Authors:OU Dan  ZHANG Yun-yan  HE Xia-yun  GU Ya-jia  HU Chao-su  YING Hong-mei  ZHU Guo-pei  WU Yong-ru  MAO Jian  SHEN Xi-gang  YUE Lei
Abstract:Objective To investigate the value of magnetic resonance sialography (MRS) as a noninvasive tool in evaluating major salivary gland function before and after radiotherapy (RT) for nasopharyngeal carcinoma patients.Methods From August 2009 to June 2010,patients with stage Ⅰ and Ⅱa (AJCC/UICC 2002) nasopharyngeal carcinoma were enrolled.All the patients were treated with intensity modulated radiation therapy alone.MRS with salivary stimulation was performed in patients before and after RT on a 3.0T MR scanner.An MRS categorical scoring system was used to compare the visibility of ducts pre-RT and post-RT.The relationship between MRS score and EORTC Core QOL and EORTC Head and Neck QOL was analyzed.Spearman rank correlation test was performed to analyze the non-stimulated and stimulated MRS findings and the clinical severity of xerostomia.Results All 10 enrolled patients completed planned treatment.The mean dose of the parotid glands and submandibular glands were (37.99 + 3.70) Gy and (55.65 + 2.99) Gy,respectively.Good-quality MRS images were obtained.The visibility scores of both the parotid and submandibular ducts were increased after secretion stimulation.Irradiation decreased the visualization of the salivary ducts and attenuated the response to secretion stimulation.There were specific correlations between post-RT secretion response of the parotid gland and EORTC QLQ scales ( global QOL scale in QLQ-C30 ( rs =0.636,P =0.048 ) and xerostomia scale in QLQ H&N35 ( rs =- 0.694,P =0.026) ).Conclusions MRS can be used as a non-invasive way to evaluated of the functional changes of major salivary glands before and after RT and as a promising approach for investigating radiation-induced xerostomia.
Keywords:Magnetic resonance sialography  Radiation-induced xerostomia  Nasopharyngeal neoplasms/radiotherapy
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