Neuro-Oncology Unit, The Royal Marsden NHS Foundation Trust, London and Sutton, UK.
Radiother Oncol. 2011 Jul;100(1):131-6. doi: 10.1016/j.radonc.2011.06.028. Epub 2011 Jul 23.
To characterise the incidence, pattern and severity of post cranial radiotherapy somnolence and to identify factors predictive of frequency and severity.
Seventy consecutive patients receiving radical cranial irradiation were prospectively assessed for somnolence at baseline, during and up to 10weeks following radiotherapy using five variables scored on a visual analogue scale (VAS) and the Littman scale. Fatigue was measured using the FACT-G score and quality of life using the EORTC QLQC30+3 with the brain tumour module questionnaire.
Ninety percent of patients experienced ⩾grade 1 somnolence (Littman score) and this correlated with VAS scores (r=0.456, p<0.001). The score increased from 3 to 12weeks (p<0.001) with a peak at the end of treatment and improvement 6weeks later. None of the patient, disease or treatment characteristics analysed were predictive for the development or the severity of somnolence.
The majority of patients experience some degree of somnolence following radical radiotherapy for primary brain tumour and this follows a clear pattern during and after treatment. While there are no clear predictors of severity, the pattern described allows for provision of information for patients and carers to minimise the distress the syndrome may cause.
描述颅后放疗后昏睡的发生率、模式和严重程度，并确定预测频率和严重程度的因素。
70 例连续接受根治性颅脑放疗的患者前瞻性地使用视觉模拟量表（VAS）和 Littman 量表上的 5 个变量在基线、放疗期间和放疗后 10 周内评估昏睡情况。使用 FACT-G 评分测量疲劳，使用 EORTC QLQ30+3 加脑肿瘤模块问卷测量生活质量。
90%的患者出现了 ⩾1 级的昏睡（Littman 评分），这与 VAS 评分相关（r=0.456，p<0.001）。评分从 3 周到 12 周（p<0.001）增加，在治疗结束时达到峰值，6 周后有所改善。在分析的患者、疾病或治疗特征中，没有任何一个可预测昏睡的发生或严重程度。
大多数患者在接受原发性脑肿瘤根治性放疗后都会出现不同程度的昏睡，这种昏睡在治疗期间和治疗后都有明显的模式。虽然昏睡的严重程度没有明确的预测因素，但描述的模式可以为患者和护理人员提供信息，以最大程度地减少该综合征可能带来的困扰。
