中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2015年
1期
33-37
,共5页
鼻咽肿瘤%癌,鳞状细胞%放射疗法,调强适形%涎腺%口腔干燥
鼻嚥腫瘤%癌,鱗狀細胞%放射療法,調彊適形%涎腺%口腔榦燥
비인종류%암,린상세포%방사요법,조강괄형%연선%구강간조
Nasopharyngeal neoplasms%Carcinoma,squamous cell%Radiotherapy intensity-modulated%Salivary glands%Xerostomia
目的 采用弥散加权磁共振成像(diffusion-weighted magnetic resonance imaging,DWMRI)动态观察鼻咽癌患者调强放疗(intensity modulated radiation therapy,IMRT)前后口干程度的变化.方法 2009年7月至2011年2月间在山西医科大学第一附属医院就诊经病理证实的鼻咽癌患者23例,男∶女为19∶4,年龄37～ 69岁.所有患者(分为平均放射剂量＜26 Gy组和≥26 Gy两组)在IMRT前、结束时、结束后6个月、12个月行静息及酸刺激下唾液腺DW MRI,并根据放射治疗肿瘤协作组和欧洲癌症研究与治疗组织制订的标准进行唾液腺损伤分级,结合患者的主观指标行口干程度临床评级.采用SPSS 13.0和SAS 8.2软件进行统计学分析.结果 IMRT结束时不同口干等级患者腮腺及颌下腺表观扩散系数(apparent diffusion coefficient,ADC)值变化趋势不同(F=11.52,P＜0.01).IMRT结束时腮腺受照剂量高的患者,口干程度重,差异有统计学意义(Z=-3.622,P＜0.01).以临床分期、治疗方式、年龄分组,IMRT结束时各组间患者发生口干严重程度差异无统计学意义(Z值分别为-0.791、-0.949、2.488,P值均＞0.05).IMRT后各随访时间点患者口干程度不同,随着时间延长,程度减轻,差异有统计学意义(x2=19.59,P ＜0.01).结论 放疗后鼻咽癌患者唾液腺功能的影响与主观口干评级间有良好的相关性.受照剂量增加,鼻咽癌患者唾液腺功能受损和口干程度加重.放疗后随时间的延长,鼻咽癌患者口干程度逐渐减轻,唾液腺功能逐步恢复.
目的 採用瀰散加權磁共振成像(diffusion-weighted magnetic resonance imaging,DWMRI)動態觀察鼻嚥癌患者調彊放療(intensity modulated radiation therapy,IMRT)前後口榦程度的變化.方法 2009年7月至2011年2月間在山西醫科大學第一附屬醫院就診經病理證實的鼻嚥癌患者23例,男∶女為19∶4,年齡37～ 69歲.所有患者(分為平均放射劑量＜26 Gy組和≥26 Gy兩組)在IMRT前、結束時、結束後6箇月、12箇月行靜息及痠刺激下唾液腺DW MRI,併根據放射治療腫瘤協作組和歐洲癌癥研究與治療組織製訂的標準進行唾液腺損傷分級,結閤患者的主觀指標行口榦程度臨床評級.採用SPSS 13.0和SAS 8.2軟件進行統計學分析.結果 IMRT結束時不同口榦等級患者腮腺及頜下腺錶觀擴散繫數(apparent diffusion coefficient,ADC)值變化趨勢不同(F=11.52,P＜0.01).IMRT結束時腮腺受照劑量高的患者,口榦程度重,差異有統計學意義(Z=-3.622,P＜0.01).以臨床分期、治療方式、年齡分組,IMRT結束時各組間患者髮生口榦嚴重程度差異無統計學意義(Z值分彆為-0.791、-0.949、2.488,P值均＞0.05).IMRT後各隨訪時間點患者口榦程度不同,隨著時間延長,程度減輕,差異有統計學意義(x2=19.59,P ＜0.01).結論 放療後鼻嚥癌患者唾液腺功能的影響與主觀口榦評級間有良好的相關性.受照劑量增加,鼻嚥癌患者唾液腺功能受損和口榦程度加重.放療後隨時間的延長,鼻嚥癌患者口榦程度逐漸減輕,唾液腺功能逐步恢複.
목적 채용미산가권자공진성상(diffusion-weighted magnetic resonance imaging,DWMRI)동태관찰비인암환자조강방료(intensity modulated radiation therapy,IMRT)전후구간정도적변화.방법 2009년7월지2011년2월간재산서의과대학제일부속의원취진경병리증실적비인암환자23례,남∶녀위19∶4,년령37～ 69세.소유환자(분위평균방사제량＜26 Gy조화≥26 Gy량조)재IMRT전、결속시、결속후6개월、12개월행정식급산자격하타액선DW MRI,병근거방사치료종류협작조화구주암증연구여치료조직제정적표준진행타액선손상분급,결합환자적주관지표행구간정도림상평급.채용SPSS 13.0화SAS 8.2연건진행통계학분석.결과 IMRT결속시불동구간등급환자시선급합하선표관확산계수(apparent diffusion coefficient,ADC)치변화추세불동(F=11.52,P＜0.01).IMRT결속시시선수조제량고적환자,구간정도중,차이유통계학의의(Z=-3.622,P＜0.01).이림상분기、치료방식、년령분조,IMRT결속시각조간환자발생구간엄중정도차이무통계학의의(Z치분별위-0.791、-0.949、2.488,P치균＞0.05).IMRT후각수방시간점환자구간정도불동,수착시간연장,정도감경,차이유통계학의의(x2=19.59,P ＜0.01).결론 방료후비인암환자타액선공능적영향여주관구간평급간유량호적상관성.수조제량증가,비인암환자타액선공능수손화구간정도가중.방료후수시간적연장,비인암환자구간정도축점감경,타액선공능축보회복.
Objective To dynamically analyze the change of xerostomia in patients with nasopharyngeal carcinoma after radiotherapy by DW MRI.Methods Twenty-three nasopharyngeal carcinoma patients confirmed by pathology were enrolled.Male / Female:19/4.The age was from 37 to 69 years.The patients were divided into two groups:G1,Dmean ＜ 26 Gy,G2,Dmean≥26 Gy.All patients underwent salivary glands examination by DW MRI before IMRT,at the end of IMRT,6 months and 12 months after IMRT,at the same time the ADC value of salivary glands were calculated.According to the RTOG/EORTC salivary gland injury grading standard and referring the subjective index,the degree of xerostomia was assessed.SPSS 13.0 and SAS 8.2 software were used to analyze the data.Results At the end of IMRT,the change tendency of ADC in parotid and submandibular glands value was different in patients with different degree of xerostomia (F =11.52,P ＜ 0.01).At the end of IMRT,a significant difference for degree of xerostomia could be found in patients within different irradiation dose groups (Z =-3.622,P ＜ 0.01).Clinical stage,treatment mode and age had no significant effect on the degree of xerostomia for patients at the end of IMRT (Z value was-0.791,-0.949,2.488,all P ＞ 0.05).A significant difference of xerostomia degree in patients was found at the various follow-up time after IMRT (x2 =19.59,P ＜ 0.01).Conclusions There is good correlation between the function of salivary gland and subjective rating of xerostomia in patients with nasopharyngeal carcinoma after radiotherapy.The degrees of salivary gland function and dry mouth in patients with nasopharyngeal carcinoma damage evaluate with illuminated dose increases.The function of salivary gland gradually restored and the degree of dry mouth gradually reduce with the extension of time after radiotherapy.
