头颈部恶性肿瘤术后放疗近期副反应的特点及影响因素

Acute side effect of postoperative ra- diotherapy in malignant head and neck neoplasm.

从1989年8月至1991年5月,160例头颈部恶性肿瘤患者在我科行手术和术后放射治疗。患者男103例,女57例;83例行原发灶根治术,77例行原发灶切除加颈淋巴清扫术;术后行原发灶和/或颈部放疗。术后放疗的近期副反应为;54例(33.8％)发生面颈部水肿,2l例(13.1％)发生头痛,7例(4.4％)因副反应严重中止放疗。研究发现,颈清扫手术类型(单侧、双侧或未颈清)是近期副反应的重要影响因素(P<0.01),手术与放疗间隔时间、放疗剂量无明显影响(P>0.05)。本文对近期副反应的临床特点、发生机理和预防问题进行了讨论。

From August 1989 to May 1991, 160 patients with malignancies of the head and neck region were treated by surgery and postoperative radiotherapy. Seventy seven patients underwent resection of the primary lesion combined with neck dissection and 83 patients had resecton of the primary lesion only before radiotherapy. After irradiation 33. 8% (54/160) patients developed edema in face and neck, 13.1% (21/160) patients developed headache. The style of neck dissection (unilateral, bilateral or no neck dissection) did significantly influence the rates of the acute side effect (P<0. 01). The interval between surgery and radiotherapy and radiation dose were not important influential factors (P>0. 05). The clinical manifestations, possible mechanism and prevention of the acute side effect is presented.