血必净注射液防治鼻咽癌急性放射性口腔黏膜炎临床观察

Efficacy of Xuebijing injection of radiotherapy-induced oral mucositis on nasopharyngeal carcinoma

目的放射性口腔黏膜炎为头颈部肿瘤放射治疗过程中最为严重的非血液学不良反应,目前尚无标准治疗方案。鼻咽癌为我国最常见的头颈部肿瘤类型。本研究旨在评估血必净注射液在鼻咽癌放射治疗中防治急性放射性口腔黏膜炎(radiotherapy-induced oral mucositis,RTOM)的有效性及安全性。方法回顾性分析2013-06-01-2018-07-31山东省肿瘤医院特需科收治的49例鼻咽癌患者,其中观察组26例,对照组23例,对照组给予康复新液口腔黏膜保护剂,观察组加用血必净注射液。两组患者均接受调强放疗。比较两组患者接受放疗过程中放射性黏膜炎发生情况及血液学不良反应。结果两组患者在放疗过程中均发生不同程度口腔黏膜炎,两组患者均未发生4级口腔黏膜炎。放疗后第3周,观察组0~3级黏膜炎分别为2、15、8和1例,对照组分别为1、7、12和3例;放疗后第4周,观察组0~3级黏膜炎分别为0、13、13和0例,对照组分别为0、2、16和5例;放疗后第5周,观察组0~3级黏膜炎分别为0、12、12和2例,对照组分别为0、0、16和7例;放疗后第6周,观察组0~3级黏膜炎分别为1、9、15和1例,对照组分别为0、1、18和4例;放疗后第3、4、5和6周,观察组放射性黏膜炎水平均低于对照组,均P<0.05。观察组3级以上严重黏膜炎发生率为11.5%(3/26),低于对照组的43.5%(10/23),χ~2=6.387,P=0.02。治疗过程中两组患者3级以上血液学不良反应差异无统计学意义,P>0.05。结论血必净注射液能够显著减少放射性口腔黏膜炎的发生率,延后发生时间,且临床应用安全。

OBJECTIVE Radiation-induced oral mucositis(RTOM)is the most several non-hematologic adverse reactions during radiotherapy of head and neck carcinoma.Nasopharyngeal carcinoma is the most common head and neck carcinoma in China.This study aimed to investigate the efficacy and safty of Xuebijing injection(XJBI)in treatment of RTOM on nasopharyngeal carcinoma.METHODS A total of 49 patients with nasopharyngeal carcinoma treated from June 2013 to July 2018 in Shandong Cancer Hospital were retrospective analysised.Totally 23 patients in control group were treated with Kangfuxin solution,while XBJI were additionally used in observation group with 26 patients.Both groups were treated with intensity-modulated radiation therapy(IMRT).Degree of RTOM and Hematological adverse reactions during therapy was compared.RESULTS Patients in both groups suffered from varying degree of RTOM.No grade 4 RTOM was happened in both group of patients.Three weeks after radiotherapy,grade 0-3 mucositis occurred in2,15,8 and 1 cases in the observation group and 1,7,12 and 3 cases in the control group.Four weeks after radiotherapy,grade 0-3 mucositis occurred in 0,13,13 and 0 cases in the observation group and 0,2,16 and 5 cases in the control group.Five weeks after radiotherapy,grade 0-3 mucositis occurred in 0,12,12 and 2 cases in the observation group and0,0,16 and 7 cases in the control group.Six weeks after radiotherapy,grade 0-3 mucositis occurred in 1,9,15 and1 cases in the observation group and 0,1,18 and 4 cases in the control group.The level of oral mucositis in observation group was significantly superior to control group at each time point(P<0.05).The incidence of grade 3 and above severe mucositis was 11.5%(3/26)in observation group and significantly lower than that(43.5%,10/23)of the control group(χ2=6.387,P=0.02).Graed 3 and 4 hematological adverse reactions between 2 groups showed no significant difference(P>0.05).CONCLUSIONS XBJI can significantly decrease the occurrence rate of RTOM and inhibit the level of oral mucositis.XBJI can delay the occurrence time of oral mucositis and is safe in clinical application.