1st Department of Radiation Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Ul. Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland.
Strahlenther Onkol. 2012 Aug;188(8):686-91. doi: 10.1007/s00066-012-0146-8. Epub 2012 Jun 24.
The goal of this research was to evaluate the healing processes of acute mucosal radiation reactions (AMRR) in patients with head and neck cancer.
In 46 patients with oral and oropharyngeal cancer patients irradiated with conventional (n = 25) and accelerated (n = 21) dose fractionation AMRR was evaluated daily during and after radiotherapy. Complex of morphological and functional symptoms according to the Dische score were collected daily until complete healing.
Duration of healing after the end of radiotherapy ranged widely (12-70 days). It was on the average 8 days longer for accelerated than for conventional radiotherapy (p = 0.016). Duration of dysphagia was also longer for accelerated irradiation (11 days, p = 0.027). Three types of morphological symptoms were observed as the last symptom at the end of AMRR healing: spotted and confluent mucositis, erythema, and edema. Only a slight correlation between healing duration and area of irradiation fields (r = 0.23) was noted. In patients with confluent mucositis, two morphological forms of mucosal healing were observed, i.e., marginal and spotted. The spotted form was noted in 71% of patients undergoing conventional radiotherapy and in 38% of patients undergoing accelerated radiotherapy. The symptoms of mucosal healing were observed in 40% patients during radiotherapy.
The wide range of AMRR healing reflects individual potential of mucosa recovery with longer duration for accelerated radiotherapy. Two morphological forms of confluent mucositis healing were present: marginal and spotted. Healing of AMRR during radiotherapy can be observed in a significant proportion of patients.
本研究旨在评估头颈部癌症患者急性黏膜放射性反应（AMRR）的愈合过程。
在 46 例接受常规（n=25）和加速（n=21）剂量分割放疗的口腔和口咽癌患者中，在放疗期间和放疗后每天评估 AMRR。根据 Dische 评分收集每日形态学和功能症状的综合表现，直至完全愈合。
放疗结束后的愈合时间差异很大（12-70 天）。加速放疗比常规放疗平均愈合时间延长 8 天（p=0.016）。吞咽困难的持续时间也更长（加速放疗 11 天，p=0.027）。在 AMRR 愈合结束时观察到三种形态学症状：点状和融合性黏膜炎、红斑和水肿。仅观察到愈合时间与照射野面积之间的轻微相关性（r=0.23）。在融合性黏膜炎患者中，观察到两种黏膜愈合的形态学形式，即边缘型和点状型。常规放疗中 71%的患者出现点状型，加速放疗中 38%的患者出现点状型。在 40%的患者中，在放疗期间观察到黏膜愈合症状。
AMRR 愈合时间范围广泛，反映了黏膜恢复的个体潜力，加速放疗的愈合时间更长。融合性黏膜炎有两种形态学愈合形式：边缘型和点状型。在相当一部分患者中可以观察到 AMRR 的愈合。
