鼻咽癌患者放疗后的嗅球体积与嗅觉功能

Olfactory bulb volume and olfactory function after radiotherapy in patients with nasopharyngeal cancer.

作者信息

Veyseller Bayram, Ozucer Berke, Degirmenci Nazan, Gurbuz Defne, Tambas Makbule, Altun Musa, Aksoy Fadullah, Ozturan Orhan

机构信息

Bezmiâlem Vakif University, Medical Faculty, Department of Otolaryngology, Fatih, Istanbul, Turkey.

出版信息

Auris Nasus Larynx. 2014 Oct;41(5):436-40. doi: 10.1016/j.anl.2014.02.004. Epub 2014 Apr 17.

DOI:10.1016/j.anl.2014.02.004

PMID:24746667

Abstract

OBJECTIVE

Radiotherapy is the primary method of treatment for nasopharyngeal cancer (NPC) and many side effects were reported in patients receiving radiation to this area. This study was conducted to evaluate the long-term effects of radiotherapy following NPC on olfactory bulb (OB) volume and olfactory function.

METHODS

Twenty-four patients with NPC who received radiotherapy at least 12 months ago were recruited. Fourteen healthy subjects with similar demographical characteristics were recruited as the healthy control group. All volunteers were subjected to a nasoendoscopical examination, and abnormalities that could potentially cause olfactory dysfunction were the exclusion criteria from the study. An experienced radiologist segmented the MRI coronal, axial and sagittal slices manually for three-dimensional OB volume measurement in a blinded manner. Olfactory function was assessed using the Connecticut Chemosensory Clinical Research Center (CCCRC) test, and average score (0: worst, 7: best) was calculated as the total CCCRC olfactory score.

RESULTS

The mean CCCRC score was 5.5 ± 1.1 for the nasopharyngeal cancer patients, whereas the mean score of healthy control group was 6.4 ± 0.4. There was a significant difference in the olfactory scores (p=0.003). The mean OB volume in the NPC group was 46.7 ± 12.1mm(3). Among the patients with NPC, the cisplatin receiving group had a mean OB volume of 47.2mm(3), whereas the cisplatin+docetaxel receiving group had a mean OB volume of 46.5mm(3), and they were similar. The MRI measurement of the healthy control group was 58.6 ± 13.8mm(3). The OB volumes of the healthy control group were significantly higher (p<0.05).

CONCLUSION

Radiotherapy following nasopharyngeal cancer results in a diminished OB volume and deteriorated olfactory function. Chemosensory olfactory dysfunction might be a contributing factor to lack of appetite, cancer cachexia and consequent lowered quality of life in NPC patients.

摘要

目的

放射治疗是鼻咽癌（NPC）的主要治疗方法，许多接受该区域放疗的患者出现了多种副作用。本研究旨在评估鼻咽癌放疗后对嗅球（OB）体积和嗅觉功能的长期影响。

方法

招募了24例至少在12个月前接受过放疗的鼻咽癌患者。招募了14名具有相似人口统计学特征的健康受试者作为健康对照组。所有志愿者均接受鼻内镜检查，可能导致嗅觉功能障碍的异常情况作为研究的排除标准。由一名经验丰富的放射科医生以盲法手动分割MRI冠状位、轴位和矢状位切片，用于三维OB体积测量。使用康涅狄格化学感觉临床研究中心（CCCRC）测试评估嗅觉功能，并计算平均得分（0：最差，7：最佳）作为CCCRC嗅觉总得分。

结果

鼻咽癌患者的CCCRC平均得分为5.5±1.1，而健康对照组的平均得分为6.4±0.4。嗅觉得分存在显著差异（p=0.003）。NPC组的平均OB体积为46.7±12.1mm³。在NPC患者中，接受顺铂治疗组的平均OB体积为47.2mm³，而接受顺铂+多西他赛治疗组的平均OB体积为46.5mm³，二者相似。健康对照组的MRI测量值为58.6±13.8mm³。健康对照组的OB体积显著更高（p<0.05）。