CAJ | 학술논문

目的比较放化疗与单纯放疗造成鼻咽癌患者感音神经性听力损失的差异性.方法 2002年3月至2007年5月新确诊鼻咽癌患者随机分为单纯放疗组与放化疗组.放疗采用调强放疗技术,化疗采用以铂类为基础方案(顺铂每天25 ms/m2,连用3 d,共4周期).治疗后1周、6个月、1年和2年分别行纯音测听检查.数据用Mann-Whitney U检验、χ2检验、Fisher's精确概率法进行分析.结果与单纯放疗组相比,放化疗组1、2年听力学检查示高频听力阈值明显升高.在单纯放疗组中位听阈损伤在治疗后立即发生,第1年内有所好转,但2年后又加重;而放化疗组中位听阈损伤在放疗后立即发生,1年后趋于稳定但无好转.结论鼻咽癌患者放化疗比单纯放疗感音神经性听力损失要重,尤其在言语听阈的高频范围.对放化疗者的内耳耐受剂量需重新界定.
목적 비교방화료여단순방료조성비인암환자감음신경성은력손실적차이성.방법 2002년3월지2007년5월신학진비인암환자수궤분위단순방료조여방화료조.방료채용조강방료기술,화료채용이박류위기출방안(순박매천25 ms/m2,련용3 d,공4주기).치료후1주、6개월、1년화2년분별행순음측은검사.수거용Mann-Whitney U검험、χ2검험、Fisher's정학개솔법진행분석.결과 여단순방료조상비,방화료조1、2년은역학검사시고빈은력역치명현승고.재단순방료조중위은역손상재치료후립즉발생,제1년내유소호전,단2년후우가중;이방화료조중위은역손상재방료후립즉발생,1년후추우은정단무호전.결론 비인암환자방화료비단순방료감음신경성은력손실요중,우기재언어은역적고빈범위.대방화료자적내이내수제량수중신계정.
Objective To compare the severity of sensorineural hearing impairment resulted from radiotherapy (RT) and radiochemotberapy (CRT) in patients with nasopharyngeal carcinoma (NPC). Methods Between March 2002 and May 2007, 100 initially diagnosed NPC patients in Shandong Tumor Hospital and Qi Lu Hospital were randomized to RT group and CRT group. All patients underwent intensity modulated radiation therapy. In CRT group, concurrent and adjuvant CDDP were administered (CDDP 25 mg/m2/d for 3 days to 4 cycles). Pure tone auditory threshold examination was performed 1 week ,6 months, 1 year and 2 years after the completion of radiotherapy. Statistical analyses were performed using Mann-Whit-ney U test,chi-square test and Fisber's exact probability test. Results The high-frequency threshold was significantly increased in CRT group comparing with RT group at 1- and 2-year after the treatment. In RT group, the hearing threshold was impaired immediately after the treatment, partially recovered within the first year but impaired again after 2 years. In CRT group, hearing threshold was impaired at the same time and kept getting worse until 1 year after radiotherapy, which could not be recovered. Conclusions Patients with NPC treated with radiotherapy and concurrent/adjuvant chemotherapy have more severe sensorineural hearing impairment comparing with those with radiotherapy alone, especially to the high frequency sound in the speech range. Inner ear tissue tolerance should be redefined for patients receiving radiochemotherapy.