鼻咽癌不同方案立体定向放疗的口腔干燥症及对生存质量的影响

Xerostomia and Its Influence on Quality of Life of the Nasopharyngeal Carcinoma Patients after Different Strategies of Stereotactic Radiotherapy

比较两种立体定向放射治疗方案对鼻咽癌患者放疗后口干燥症的情况及其对日常生活的影响。选择放疗后满3年复查的鼻咽癌患者91例，按照单纯立体定向照射和面颈联合野联合立体定向照射分为A组和B组。复查时进行面对面访谈方式的口干问卷调查，根据调查结果分析口干燥症的严重程度及其对生存质量的影响。A组1年局控率91．80％（56／61），1、2、3年累积生存率为96，72％（59／61）、93．22％（57／61）、91．80％（56／61）。腮腺受照剂量16．69～32．67Gy（20．21±5．36）Gy，口干燥症的发生率为6．56％（4／61），中度发生率为3．28％（2／61），无重度发生。其中3．28％（2／61）的患者吃饭时需饮水，无患者夜晚经常喝水或说话时感口干，3．28％（2／61）的患者认为日常生活明显受影响。B组1年局控率96．67％（29／30），1、2、3年累积生存率为96．67％（29／30）、93．33％（28／30）、90．00％（27／30）。腮腺受照剂27．47～40．28Gy（28．25±10．19）Gy，口干燥症的发生率为46．67％（14／30），中度发生率为23．33％（7／30），重度2例（6．67％）。其中33．33％（10／30）患者吃饭时需饮水，13．33％（4／30）患者夜晚经常喝水或感到说话困难，43．33％（13／30）患者认为日常生活明显受影响。两组比较1年局控率和生存率差异无统计学意义，口干燥症的发生率差异有统计学意义（P〈0．05）。单纯立体定向放射治疗鼻咽癌可以保证局部控制率和生存率，减少放疗后口干燥症，提高患者的生存质量。

To compare xerostomia and its effect on quality ferent strategies of stereotactic radiotherapy, 91 nasopharyng of life of nasopharyngeal carcinoma patients after difeal carcinoma patients were divided into A and B groups by two different strategies. All were given a questionnaire of clinic regarding xerostomia after 3 year radio： therapy. Its severity and effect on the quality of life were studied. The result show that in A group, the local control rate was 91.80% （56/61）, and the 1 - ,2 - ,3 - year survival rate were 96.72% （59/61） ,93.22% （57/61） ,91. 80% （56/61） respectively. The dose of parotid was 16.69 - 32.67 Gy （20.21 ± 5.36） Gy. 6.56 % （4/61） Xerostomia was found in A group. Moderate xerostomia occurred in 3.28% （2/61） of the patients. No severe occurred. 3.28% （2/61） thought that their daily life was effected significantly. In B group,the local control rate was 96.67% （29/30）, and the 1 -, 2 -, 3 - year survival rate were 96.67 % （29/30） ,93.33 % （ 28/30 ） ,90.00% （ 27/30 ） re- spectively. The dose of parotid was 27.47 - 40.28 Gy（ 28.25 ± 10.19 ） Gy. 46.67% （14/30） Xerostomia was found in B group. The moderate and severe xerostomia were 23.33 % （7/30）, 6.67% （2/30） respectively. Of all, 33. 33% （10/30） needed to drink water while eating, 13.33% （4/30）often drank water at night or felt difficulties speaking, and 43.33 % （13/30） thought that their daily life was effected significantly. The local control rates and survival rates were no siginificanfly different and the xerostomia occurring rates were different significantly between the two group. The only stereotactic radiotherapy can acquire the same local control rate and the survival rate of nasopharyngeal carcinoma patients. It also can decrease the rate of xerostomia and improve the quality of life.