苦豆子总碱温敏凝胶治疗头颈部肿瘤同步放化疗期间放射性皮炎和口咽炎的疗效观察

Efficacy of total alkaloid of thermo-sensitive gel of sophora alopecuroides in treating radiodermatitis and radiation pharyngitis during concurrent chemoradiotherapy for head and neck cancer

目的观察苦豆子总碱温敏凝胶治疗头颈部肿瘤同步放化疗期间放射性皮炎和口咽炎的临床疗效。方法选取90例头颈部肿瘤同步放化疗的患者,随机分为2组:以苦豆子总碱温敏凝胶为皮肤和口咽黏膜保护剂(A组);以三乙醇胺乳膏为皮肤保护剂(B组)、自配消炎止痛液为口咽黏膜保护剂。2组放疗均采用6 m V的X线,每次2.0 Gy,1次/天,5次/周,总照射剂量为58—70 Gy,放疗期间均行顺铂(25 mg/m2)单周方案同步化疗。放疗开始将保护剂涂于面部、颈部及口咽部,至放疗结束停药。观察2组放射性皮炎及口咽炎发生时的剂量、严重程度及口咽疼痛情况。结果在放射性皮炎发生时的剂量、程度方面,A组与B组差异无统计学意义(P>0.05);在放射性口咽炎发生时的剂量、程度方面,A组与B组有统计学意义(P<0.05);2组口咽部疼痛情况比较差异有统计学意义(P<0.05)。结论苦豆子总碱温敏凝胶治疗头颈部肿瘤同步放化疗期间放射性皮炎的效果与三乙醇胺乳膏相当,治疗放射性口咽炎效果优于消炎止痛液,能有效地治疗放射性皮炎及口咽炎,并能延长放射性口咽炎发生的时间,减轻口咽部疼痛。

Objective To observe the clinical efficacy of total alkaloid of sophora alopecuroides thermo-sensitive gel in the treatment of radiodermatitis and radiation pharyngitis during concurrent chemoradiotherapy for head and neck cancer.Methods 90 head and neck cancer patients,treated in the Radiotherapy Department,First Hospital of Lanzhou University,from January 2011 to September 2016,were randomly divided into two groups：group A used sophora alopecuroides thermo-sensitive gel as a protective agent for skin and oropharynx mucosa and group B used biafine cream for skin protective agent and anti-inflammatory analgesic liquid for oropharyngeal mucosal protective agent.The two groups of radiotherapy were treated with 6 m V X-ray,2 Gy/times,1 times/day,5 times/week,and the total dose was 58 to 70 Gy.Cisplatin（25 mg/m^2） single week regimen of concurrent chemotherapy was performed during the radiotherapy.In the two groups,the protective agent was applied to the face,neck and oropharynx from the beginning to the end of radiotherapy.The dose and degree of radiodermatitis,pharyngitis and the pain of oropharynx were observed in the two groups.Results There was no significant difference between the two groups in the dose and extent of radiodermatitis（P〈 0.05）,while a significant difference existed between the two groups in the dose and extent of radiation pharyngitis（P〈 0.05）.There was significant difference in pharyngeal pain between the two groups（P〈 0.05）.Conclusion Sophora alopecuroides thermo-sensitive gel has the similar effect of biafine cream in treating radioadermatitis and has better effect than anti-inflammatory analgesic liquid in treating radiation oropharyngitis during concurrent chemoradiotherapy for head and neck cancer.Sophora alopecuroides thermo-sensitive gel could treat radiodermatitis and radiation pharyngitis,prolong the time of occurrence and reduce oropharyngeal pain.