鼻咽癌放疗性角膜损伤的跟踪研究(英文)

A follow-up study on keratopathy in eyes after radiation therapy for nasopharyngeal carcinoma

目的:探讨鼻咽癌(NPC)放射治疗眼部并发症。方法:对 213 例 NPC 初程放疗患者进行跟踪观察。放疗前、放疗中及放疗后作视功能(包括远视力、裂隙灯活体显微镜、眼底、自动电脑视野及视诱发电位)检查和角膜荧光素染色。结果:发生角膜损伤 19 例,占 8.9 %(19/213)。I～Ⅱ期6 例,Ⅲ期 8 例,Ⅳ期 5 例。全部发病患者均无角膜刺激症状,放疗后 10mo 内,角膜病变消退,但知觉仍较对侧眼明显减退;20mo 后尚未恢复正常。未发现晶状体混浊的患者。结论:NPC 放疗性角膜损伤与鼻咽癌临床分期及照射剂量无密切关系(P>0.05),可能主要与角膜感觉神经损伤导致眼表疾病密切相关;不排除患者不同个体对辐射的敏感差异性。

AIM： To investigate the ocular complication after radiation therapy for nasopharyngeal carcinoma（NPC）. METHODS： The authors performed a previous study on keratopathy in 213 NPC patients who received first stage radiation and had at least 10 months of follow-up. These patients were categorized into three groups depending on NPC clinic stages. Rates and proportions of keratopathy occurring in these groups were compared and analyzed with Chi-square Test and Spearman rank correlation coefficient. RESULTS： Radiation keratopathy developed in 19 patients, about 8.9% （19/213）. The latency value was 3 to 30 days. The effect of NPC clinic stages and radiation did on the development of keratopathy was not statistically significant （p〉0.05）. CONCLUSION： The NPC clinic stages and radiation doses plays few effects on the development of keratopathy. It may play a key role that corneal nerves damage induced ocular surface diseases. It can not be excluded that individuals have different sensitivities to radiation.