鼻咽癌放疗中个体化口腔支架对味觉的保护作用

The role of individual dental stent on taste protection in the patients with primary nasopharyngeal carcinoma treated with radiotherapy

目的探讨个体化的口腔支架（简称口腔支架）在鼻咽癌放射治疗过程中对味觉的保护作用。方法剂量学上,选取10对合适的患者,分为佩戴和不佩戴口腔支架组,分别分析其舌尖、舌体、舌根受照射的剂量。临床上,将61例鼻咽癌患者随机分为试验组29例和对照组32例,其中试验组患者在放疗过程中佩戴个体化口腔支架,而对照组不佩戴。放疗前、放疗中每周检查两组患者基本味觉情况,放疗后随访6个月。结果佩戴与不佩戴口腔支架患者舌尖、舌体、舌根所受平均照射剂量的平均值分别是（394.43±24.01）cGy、（986.35±77.15）cGy、（4 401.16±179.01）cGy和（677.03±110.05）cGy、（2 418.19±414.18）cGy、（4 878.67±387.45）cGy。患者佩戴口腔支架后舌尖和舌体的受照射剂量均较不佩戴者下降（P=0.031,P=0.007）,两组舌根受照射剂量差异无统计学意义（P=0.284）。临床上,放疗结束时试验组有9例（31.03 %）患者出现味觉减退,对照组患者有25例（78.13 %）出现味觉减退,差异有统计学意义（P〈0.001）。结论个体化的口腔支架对于放射治疗鼻咽癌患者的味觉具有一定的保护作用。

ObjectiveTo investigate the role of individual dental stent on taste protection in the patients with primary nasopharyngeal carcinoma. MethodsFirstly, dosimetric evaluation of the tongue under the circumstance of 10 pairs of patient wearing dental stent or not was done. Secondly, a total of 61 patients were randomized into two arms： 29 were in the trial arm and 32 in the control arm. The patients wore dental stent during radiotherapy in trial group, but not in control group. The endpoint was taste dysfunction before radiotherapy, every week during radiotherapy till the completion of radiotherapy, and followed up six months after radiotherapy. ResultsThe mean dose of tip of tongue, body of tongue, base of tongue for patient with dental stent or not were （394.43±24.01） cGy, （986.35±77.15） cGy, （4 401.16±179.01） cGy and （677.03±110.05） cGy, （2 418.19±414.18） cGy, （4 878.67±387.45） cGy （P value were 0.031, 0.007 and 0.284, respectively） separately. By the completion of the radiotherapy, there were 9 （31.03 %） patients suffering from a taste dysfunction in the trial group and 25 （78.13 %） in the control group （P 〈 0.001）. ConclusionsIndividual dental stent has a potential tendency to relieve the taste impairment by reducing the irradiation dose of tongue.