摘要
背景与目的:口干燥症是鼻咽癌放疗后最常见的后遗症之一,它严重影响患者放疗后的生存质量。本研究旨在探讨颌下腺移位术预防鼻咽癌放疗后口干燥症的临床效果。方法:共选择70例病例进行前瞻性非随机临床对照研究。试验组选择符合入选标准的鼻咽癌患者36例,在放疗前将颌下腺移位至颏下区,术后接受常规放疗,放疗时颏下区设置挡块。观察放疗中急性口腔粘膜反应,应用锝-99核素扫描检测放疗前后颌下腺功能的变化,测定放疗前后唾液分泌量的变化,放疗后3个月进行口干程度问卷调查。对照组(34例)不行颌下腺移位术,其余处理方法同试验组。将试验组的术侧与非术侧以及试验组与对照组的上述观察指标进行比较。结果:试验组急性口腔粘膜反应明显轻于对照组(P=0.007)。试验组放疗后3个月移位术侧颌下腺摄取、排泌功能均明显较未移位术侧者好,两者之间有非常显著性差异(P值分别为0.001和0.000);试验组颌下腺摄取、排泌功能均明显较对照组者好,两者之间有非常显著性差异(P值分别为0.004和0.000)。试验组放疗后唾液分泌量的平均值为1.41g,而对照组放疗后唾液分泌量平均值为0.71g。对照组76.5%的患者有中度至重度的口干燥症,试验组仅13.9%的患者有中度至重度的口干燥症,两者之间有非常显著性差异(P=0.000)。
BACKGROUND & OBJECTIVE: Xerostomia, an ubiquitous sequelae in nasopharyngeal carcinoma (NPC) patients after radiotherapy, seriously affects life quality of the patients. This study was to investigate clinical value of submandibular salivary gland transfer in preventing radiation-induced xerostomia of NPC patients. METHODS: A total of 70 eligible patients with NPC were recruited, and divided into test group (36 patients) and control group (34 patients). In test group, the submandibular glands were transferred to the submental spaces before conventional radiotherapy. The submental spaces were shielded during radiotherapy. Oral cavity mucous membrane reaction during radiotherapy, submandibular gland function and salivary fluid before and after radiotherapy, and questionnaire of xerostomia 3 months after radiotherapy were compared between test group and control group. RESULTS: Acute oral cavity mucous membrane reaction was severer in control group than in test group; the incidence of stage Ⅲ reaction was significantly higher in control group than in test group ( 8/34 vs. 3/36, P = 0.007). Three months after radiotherapy, trapping and excretion functions of the transferred submandibular glands were significantly better than those of the untransferred submandibular glands in test group (P = 0.001 and P = 0.000); trapping and excretion functions of the submandibular glands were significantly better in test group than in control group (P = 0.004 and P = 0.000). The mean weight of salivary fluid after radiotherapy was heavier in test group than in control group (1.41 g vs. 0.71 g). Incidence of moderate to severe degree of xerostomia was significantly higher in test group than in control group (76.5% vs. 13.9%, P = 0.000). CONCLUSION: Submandibular gland transfer may be used to prevent radiation-induced xerostomia of NPC patients, and may improve life quality of the patients.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2005年第5期577-581,共5页
Chinese Journal of Cancer
基金
广东省医学科学技术研究基金(No.A2004576)~~
关键词
鼻咽肿瘤
放射治疗
口干燥症
预防
颌下腺移位术
Nasopharyngeal neoplasms
Radiotherapy
Xerostomia
Prevention
Submandibular gland transfer
