鼻咽癌放射治疗后第Ⅹ颅神经损伤临床分析

Radiation induced vagus nerve injury in nasopharyngeal carcinoma

目的探讨鼻咽癌放射治疗后第Ⅹ颅神经损伤的临床特点、诊断、治疗、预后及影响其发生的相关因素。方法对该院1990年4月至2004年7月诊治的38例鼻咽癌放射治疗后第Ⅹ颅神经损伤患者的临床资料进行回顾性分析。结果22例在早期用激素、抗生素、大量维生素等药物治疗,7例症状轻微改善,10例无明显变化,5例病情进展。随访34例,死亡14例,现生存20例,出现神经损伤后生存1￣14年。结论放射性第Ⅹ颅神经损伤缺乏特异性的治疗手段,其发生与照射剂量、照射体积、照射技术及分次剂量等因素有关。

Objective To study the clinical features, diagnosis, treatment,prognostic factors and causes of patients with radiation induced vagus nerve injury in nasopharyngeal carcinoma. Methods Thirty-eight patients of radiation induced vagus nerve injury found in our hospital from April 1990 to July 2004 were analyzed retrospectively. Results Twenty-two patients were treated with dexamethasone, antibiotic and vitamin in the early phase, with symptoms lightly relieved in 7 patients, but unimproved in 10 patients, became worse in 5 patients. Thlrty-four patients were followed up, 14 patients died, leaving 20 patients surviving for 1 to 14 years. Conclusions There were no effective treatment methods for radiation injury of vagus nerve. The incidence of radiation induced vagus nerve injury is associated with irradiation dose, irradiation volume,radiotherapy technique and fractional dose.