鼻咽癌患者放疗后不良反应调查研究

Investigation of adverse reactions in nasopharyngeal carcinoma patients after radiotherapy

目的 观察分析鼻咽癌患者放疗后急性和晚期副反应情况。方法 对门诊随访的89例鼻咽癌患者进行填表调查，随访的中位时间为3年（2年-23年）。结果 急性期发生率较高的反应主要有严重口干，耳鼻反应；晚期共79.8%患者出现放射性中耳炎表现，其中53.9%患者出现听力下降，42.7%出现鼻腔症状，11.2%仍存在重度口干，66.3%患者发生2度以上的龋齿。结论 同10几年前相比鼻咽癌患者发生严重晚期并发症的发生率有所降低，但放射性中耳炎和放射性龋齿的发生率仍较高，同步化疗可能增加或加重急性期放疗反应，但并未对晚期不良反应的发生造成影响。

Objective To observe the adverse reactions of acute stage and late stage in nasopharyngeal carcinoma patients after radiotherapy. Methods 89 patients were investigated in the outpatient department by form. The median follow-up time was 3 years （2-23 years）. Results In the acute stage, the ratios of serious xerostomia [78.7 %（70/89）], the ear reaction [66.3 % （59/89）] and nose impairment [64.0 % （57/89）] were very high.In the late stage 79.8 % （71/89） patients developed radioactive tympanitis, in which 53.9 % （48/89） patients induced hearing loss, 42.7 % （38/89） patients developed dry nose or nasal excessive discharge. The rate of serious xerostomia was 11.2 % （10/89）, 66.3 %（59/89） patients suffered from superficial and more serious caries. Conclusion The rates of the radioactive tympanitis and caries stayed high in the late stage of nasopharyngeal carcinoma patients after radiotherapy. Concurrent ehemoradiotherapy is probable to increase or aggravate the incidence of adverse reactions in the acute stage, but don＂ t show an effect on the late stage reaction.