Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Head Neck. 2012 Jul;34(7):985-93. doi: 10.1002/hed.21848. Epub 2011 Sep 26.
Current evaluation of radiation-induced mucositis in head and neck cancer relies on subjective scoring with interrater variability. We evaluated serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) as objective markers of radiation-induced mucositis.
Weekly serum CRP and ESR levels were measured in patients treated for head and neck cancer with radiation ± chemotherapy. Acute radiation toxicity was evaluated using National Cancer Institute of Canada-Common Toxicity Criteria (NCIC-CTC) version 2.0 and the Head and Neck Radiotherapy Questionnaire (HNRQ).
ESR and CRP levels were significantly elevated by 3 weeks (p = .01) and 6 weeks (p = .0002), respectively, and independent of age or pretreatment surgery. ESR was significantly dependent on radiation dose (p = .0004) and significantly higher with chemoradiation (p = .03).
Serum ESR and CRP rise reliably in a radiation dose-dependent manner. ESR correlated with clinical symptoms and distinguished patients receiving chemoradiation. ESR and CRP may be an objective and sensitive marker of radiation-induced mucositis.
目前对头颈癌放射性粘膜炎的评估依赖于具有观察者间变异性的主观评分。我们评估了血清红细胞沉降率（ESR）和 C 反应蛋白（CRP）作为放射性粘膜炎的客观标志物。
每周测量接受头颈部癌症放射治疗±化疗的患者的血清 CRP 和 ESR 水平。使用加拿大国家癌症研究所-常见毒性标准（NCIC-CTC）版本 2.0 和头颈部放射治疗问卷（HNRQ）评估急性放射毒性。
ESR 和 CRP 水平分别在第 3 周（p =.01）和第 6 周（p =.0002）显著升高，且与年龄或术前手术无关。ESR 与辐射剂量显著相关（p =.0004），且放化疗时显著更高（p =.03）。
血清 ESR 和 CRP 以辐射剂量依赖性的方式可靠地升高。ESR 与临床症状相关，并可区分接受放化疗的患者。ESR 和 CRP 可能是放射性粘膜炎的客观和敏感标志物。
