下颌下腺移位预防鼻咽癌放疗后口干燥症的长期疗效

Long-term efficacy of submandibular gland transfer for prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma

目的:评价下颌下腺移位预防鼻咽癌放疗后口干燥症的长期疗效。方法:65例鼻咽癌患者随机分为试验组32例和对照组33例。试验组在行常规放疗前将下颌下腺移位至颏下区,放疗时颏下区设置挡块。2组患者放疗前行下颌下腺造影检测下颌下腺功能,放疗后60个月采用99mTc核素扫描检测放疗后下颌下腺功能并进行口干程度问卷调查,且统计5年生存率。结果:放疗后60个月试验组下颌下腺摄取及分泌功能均明显较对照组好,差异均有统计学意义(P<0.01);试验组中度至重度口干燥症的发生率亦显著低于对照组,分别为15.4%和76.9%(P<0.01);试验组和对照组的5年生存率分别为81.3%和78.8%,两者之间差异无统计学意义(P>0.05)。结论:下颌下腺移位预防鼻咽癌放疗后口干燥症的长期疗效较好,可改善鼻咽癌患者放疗后的生存质量,不影响鼻咽癌的远期疗效。

Objective：To evaluate the long-term efficacy of submandibular gland transfer for prevention of xer- ostomia after radiotherapy for nasopharyngeal carcinoma. Method：Sixty-five cases of nasopharyngeal carcinoma pa- tients were randomly divided into study group of 32 patients and control group of 33 patents. The submandibular gland was transferred to submental region on 32 cases with nasopharyngeal carcinoma before receiving conventional radiotherapy and a block was used to cover the submental region. Before radiotherapy, two groups of submandibu- lar gland function was detected by imaging of the submandibular gland. At 60 months after radiotherapy, subman- dibular gland function was detected by 99m TC radionuclide scanning, the questionnaire about the degree of xerosto- mia was investigated respectively. Five-year survival rate was counted. Result.. After following up for 60 months, submandibular gland uptake and secretion function in the study group was significantly higher than that in the con- trol group, there was significant difference between the two groups（P〈0.01） respectively. The incidence of mod- erate or severe xerostomia in the study group was significantly lower than that in the control group（15.4% vs 76.9% ,P〈0.01）. Five-year survival rate of the study group and control group was 81.3% and 78.8% respec- tively, there was no significant difference between the two groups（P〈0.05）. Conclusion：The long-term efficacy of submandibular gland transfer for prevention of xerostomia after radiotherapy for nasophatyngeal carcinoma was well. It could improve the quality of life in nasopharyngeal carcinoma patients after radiotherapy, and did not af- fect the long-term efficacy of nasopharyngeal carcinoma.