鼻咽癌调强放疗与三维适形放疗口干燥症的对比研究

A Comparative Study of Xerostomia after Intensity-modulated Radiotherapy and Three-dimensional Conformal Radiotherapy for Nasopharyngeal Carcinoma

目的:观察鼻咽癌患者调强放疗(IMRT)和三维适形放疗(3D-CRT)后口干燥症的程度。方法:分析本院初治鼻咽癌患者85例,其中调强放疗组45例,三维适形放疗组40例。按照RTOG/EORTC急性放射损伤分级标准分别于放疗结束时、放疗后3个月和6个月时评价患者口干程度。结果:放疗结束时,IMRT组口干症状多为1、2级,3D-CRT组口干症状多为2、3级,两组比较差异有统计学意义(Z=-6.58,P<0.05);放疗后3个月,IMRT组口干症状有一定缓解,3D-CRT组无明显好转,两组比较差异有统计学意义(Z=-7.7,P<0.05);放疗后6个月,IMRT组和3D-CRT组口干症状与各自放疗后3个月比较差异均无统计学意义(Z=-0.5,P>0.05;Z=-0.1,P>0.05),但两组比较差异有统计学意义(Z=-7.9,P<0.05)。结论:调强放疗可明显减轻鼻咽癌患者放疗后的口干燥症,能够提高患者与口腔健康相关的生存质量。

Objective： To observe the influence of intensity-modulated radiotherapy （tMRT） and three- dimensional conformal radiotherapy （3D-CRT）on the xerostomia in patients with nasopharyngeal carcinoma.Method： 85 patients with primary nasopharyngeal carcinoma （ NPC ） in our hospital were analyzed.Among them, forty NPC patients without previous radiotherapy underwent 3D-CRT and another forty-five received IMRT.The levels of mouth dryness were evaluated at the end of radiotherapy, 3 months and 6 months after radiotherapy according to RTOG/EORTC acute radiation injury grading standards.Result： At the end of radiotherapy, the majority of the IMRT group was level 1 and 2 on xerostomia symptoms, the 3D-CRT group was level 2 and 3, there was a significant difference between two groups （Z=-6.58, P〈0.05 ） .After 3 months of radiotherapy, the IMRT group could relieve the symptoms of xerostomia, there was no obvious improvement in 3D-CRT group, there was a significant difference between two groups （ Z=-7.7, P〈0.05 ） .Compared with 3 months after radiotherapy in each group, there were no statistically significant differences in the symptoms of xerostomia after 6 months of radiotherapy in the IMRT group and 3D-CRT group （ Z=-0.5, P〉0.05 ; Z=-0.1, P〉0.05 ）, but the difference was statistically significant between the IMRT group and 3D-CRT group （ Z=-7.9, P〈0.05 ） .Conclusion： IMRT in the treatment of patients with nasopharyngeal carcinoma can reduce the xerostomia after radiotherapy and improve the quality of life associated with oral health.