康复新液联合核黄素磷酸钠治疗头颈部肿瘤放射性口腔黏膜炎的疗效分析

Effect of Kangfuxin Liquid Combined with Riboflavin Sodium Phosphate in the Treatment of Radiotherapy-Induced Oral Mucositis in Head and Neck Cancer Patients

目的:观察康复新液联合核黄素磷酸钠治疗头颈部肿瘤放射性口腔黏膜炎的疗效。方法:选取我院2017年6月至2019年6月经病理确诊且无远处转移的头颈部恶性肿瘤患者129例纳入研究,采用随机法分为实验组(康复新液联合核黄素磷酸钠组)和对照组(单药使用康复新液组和核黄素磷酸钠组)。3组患者均行根治性调强放疗且放疗开始即使用药物防治黏膜炎直至放疗结束。采用美国放射肿瘤治疗协作组口腔黏膜炎分级标准及VAS疼痛评分,评价3组患者在治疗过程中口腔黏膜炎损伤程度及口腔疼痛程度以及药效安全。结果:3组患者均出现了不同程度的放射性口腔黏膜炎及口腔疼痛。治疗第2周末时,3组患者放射性口腔黏膜炎损伤程度的差异无统计学意义(χ^(2)=2.186,P=0.335),但随着放疗剂量增加,在治疗第4周末及第6周末时,实验组的放射性口腔黏膜炎损伤程度主要集中在I~II级,而对照组主要集中在III~IV级,实验组黏膜炎损伤程度较对照组轻,差异有统计学意义(P<0.05)。3组患者口腔疼痛VAS评分也随着放疗剂量的增加逐渐升高,在治疗第2周末时,实验组与康复新液组口腔疼痛VAS评分的差异无统计学意义(P>0.05),与核黄素磷酸钠组相比,口腔疼痛程度较轻,差异有统计学意义(P<0.05);在治疗第4、6周末时,实验组的口腔疼痛程度显著轻于对照组,差异有统计学意义(P<0.05)。所有入组患者均未出现严重的药物相关不良反应。结论:康复新液联合核黄素磷酸钠较单独使用康复新液或核黄素磷酸钠可以更好地预防和治疗头颈部肿瘤的放射性口腔黏膜炎,能降低口腔黏膜炎的严重程度,减轻口腔疼痛,进一步提高放化疗患者的耐受力,无严重不良反应,值得临床推广。

Objective:To evaluate the efficacy of Kangfuxin liquid combined with riboflavin sodium phosphate in the treatment of radiotherapy-induced oral mucositis(RTOM)in head and neck cancer patients.Methods:A total of 129 pathologically diagnosed head and neck cancer patients without distant metastasis in our hospital from June 2017 to June 2019 were selected,and were randomly assigned to the Kangfuxin+riboflavin group(the use of Kangfuxin liquid combined with riboflavin sodium phosphate),the Kangfuxin group(the single use of Kangfuxin liquid)and the riboflavin group(the single use of riboflavin sodium phosphate).All patients were treated with radical radiotherapy,and drugs were used to prevent mucositis during radiotherapy.Pain and oral mucositis in patients were evaluated by Visual Analogue Scale(VAS)and standards for RTOM made by Radiation Therapy Oncology Group(RTOG),respectively.The degree of RTOM and oral pain,as well as the efficacy and safety of drugs were evaluated among the three groups.Results:Different degrees of RTOM and oral pain were observed in three groups.At the end of the second week,there was no significant difference in the degree of RTOM among the three groups(χ^(2)=2.186,P=0.335).With the increase of radiation dose,RTOM in the Kangfuxin+riboflavin group(mainly in grade I and II)was milder than that in other two groups(mainly in grade III and IV)at the end of the 4th and 6th weekend(P<0.05).Also,the VAS score of oral pain in three groups increased gradually as the radiation dose increased.At the end of the second week,difference in the VAS score of oral pain between the Kangfuxin+riboflavin group and the Kangfuxin group was not significant(P>0.05),but was significant between the Kangfuxin+riboflavin group and the riboflavin group(P<0.05).At the end of 4th and 6th weekends,oral pain in the K angfuxin+riboflavin group was significantly milder than that in other two groups(P<0.05).No serious drug-related adverse reactions occurred.Conclusion:Compared with the single use of Kangfuxin liquid or riboflavin sodium phosphate,Kangfuxin liquid combined with riboflavin sodium phosphate can better prevent and treat RTOM in head and neck cancers patients,alleviate oral mucositis and oral pain,further improve the tolerance of patients to radiotherapy and chemotherapy,and without serious adverse reactions,which is worthy of clinical promotion.