鼻咽癌调强放疗不良反应的预防及处理

Prevention and treatment of adverse reactions in intensity modulated radiation therapy for nasopharyngeal carcinoma

目的对鼻咽癌调强放疗相关不良反应的预防及处理措施进行探讨，提高放疗期间的安全性。方法选取我院2011年2月～2013年5月收治的80例接受调强放疗的鼻咽癌患者，按照人院顺序分为干预组与对照组各40例，干预组给予不良反应预防措施，对照组不给予相关措施，比较两组患者放疗中及治疗后的不良反应情况。结果干预组40例患者出现急性皮肤反应（0～2级）38例，消化道反应5例，骨髓抑制（3级）4例，口腔黏膜急性反应2例；对照组40例患者出现急性皮肤反应（0～3级）40例，消化道反应11例，骨髓抑制（3级）8例，口腔黏膜急性反应6例。干预组放疗期间不良反应发生率及程度均低于对照组（P〈0．05），具有统计学意义。结论对鼻咽癌调强放疗患者实施相关预防措施可有效降低放疗期间不良反应发生率。

Objective To explore the prevention and treatment measures of related adverse reactions in intensity modulated radiation therapy for nasopharyngeal carcinoma, and improve the safety during the radiotherapy. Methods 80 cases with nasopharyngeal carcinoma who received the intensity modulated radiation therapy in our hospital from February 2011 to May 2013 were divided into the intervention group and the control group according to the order of admission, each group had 40 cases. The patients in the intervention group were given the preventive measures of adverse reactions, while the patients in the control group were not given the relevant measures, and the adverse reactions of patients in the two groups during and after the radiation therapy were compared. Results In 40 patients of the intervention group, there were 38 cases with acute skin reactions（0 - 2 grade）, 5 cases with gastrointestinal reactions, 4 cases with bone marrow depression（3 grade）, 2 cases with acute oral mucosa reactions; In 40 patients of the control group, there were 40 cases with acute skin reactions（0 - 3 grade）, 11 cases with gastrointestinal reactions, 8 cases with bone marrow depression（3 grade）, 6 cases with acute oral mucosa reactions. The incidence and degree of adverse reactions during＂ the radiation therapy in the intervention group were lower than those in the control group （P 〈 0.05）, and the differences were statistically significant. Conclusion The implementation of relevant preventive measures can effectively reduce the incidence of adverse reactions during the radiation therapy in patients with nasopharyngeal carcinoma receiving the intensity modulated radiation therapy.