同步放化疗对中晚期鼻咽癌患者听觉功能的影响

The effect of radiotherapy combined with synchronous chemotherapy on auditory function of patients with advanced nasopharyngeal carcinoma

目的：评价和比较同步放化疗与序贯治疗对中晚期鼻咽癌听觉功能的影响。方法：44例中晚期鼻咽癌患者随机分入同步治疗组和序贯治疗组。两组患者均在放疗前、放疗开始后1月和放疗结束后（1个月、3个月、6个月、12个月）检查纯音听阈和鼓室导抗图。结果：同步治疗组患者的听力损害大于序贯治疗组（P〈0．05）。放疗后1个月同步治疗组患者的语频（0．5～4．0kHz）和高频（8kHz）平均骨导听阈较治疗前分别提高7．2dB和25．5dB，而序贯治疗组分别提高了15．2dB和36．8dB，两组差异有统计学意义（P〈0．05）。结论：同步治疗组患者的听力损害较序贯治疗组发生早、发生率高、程度重。

Objective：To evaluate the effect of radiotherapy combined with synchronous chemotherapy on auditory function of patients with nasopharyngeal carcinoma. Methods：Forty-four patients with advanced nasopharyngeal carcinoma were divided into synchronous group and sequential group randomly. They were examined for pure-tone threshold average and tympanometry before and after therapy. Results： Auditory of patients in the synchronous group decreased more than sequential group （ P 〈 0. 05 ）. One month after RT, there were 7. 2 dB and 25.5 dB increased in mean bone conduction （ BC ）thresholds at speech （0. 5 -4.0 kHz）and high frequency （8.0 kHz）in the synchronous group,and there were 15.2 dB and 36. 8 dB increased in mean BC thresholds at speech and high frequency in the sequential group （P 〈 0. 05 ）. Conclusion：The hearing impairment starts soon after radiotherapy combined with synchronous chemotherapy. The incidence and the extent of hearing loss of patients in the synchronous group are more than sequential group.