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调强放射治疗对鼻咽癌患者生活质量的影响。

Influence of Intensity-Modulated Radiation Therapy on the Life Quality of Patients with Nasopharyngeal Carcinoma.

作者信息

Chen Jianwu, Liu Ping, Wang Qian, Wu Lifang, Zhang Xingping

机构信息

Department of Radiation Oncology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, Fujian, China.

Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

出版信息

Cell Biochem Biophys. 2015 Dec;73(3):731-6. doi: 10.1007/s12013-015-0638-0.

Abstract

The present study intends to explore the influence of intensity-modulated radiation therapy on the quality of life for patients with nasopharyngeal carcinoma, which provides a theoretical basis and practical foundation for clinical practice. The present study randomly enrolled 130 cases of patients with nasopharyngeal carcinoma (NPC) in different stages who were admitted in The Second Affiliated Hospital of Fujian Medical University and the First Affiliated Hospital of Chongqing Medical University from September 2007 to August 2012, including 65 cases in IMRT group who received intensity-modulated radiation therapy and 65 cases in CRT group who received conventional radiation therapy. The prescribed dose in the target region of radical radiation therapy was 72 Gy/36 f; the prescribed dose in the target region at high risk was 60-64 Gy/30-32 f; the prescribed dose in the target region at low risk was 50-54 Gy/25-27 f and 2 Gy/f, with conventional fractionated irradiation of 1 f/d and 5 f/w. The data of the quality of life for patients with NPC who received intensity-modulated radiation therapy and conventional radiation therapy were collected and analyzed by filling in the questionnaire survey, including the Quality of Life Questionnaire of Head and Neck 35 (QLQ-H&N35) and Shot Form 36 Health Survey Questionnaire (SF-36). RP, VT, BP, SF, and RE scores in eight fields in SF-36 Scale were declined during the radiation therapy and risen again after radiation therapy, and those measured at 6 months after radiation therapy were higher than those before radiation therapy (all P < 0.05). The scores in IMRT group measured at two and six months after radiation therapy were all higher than those in CRT group (all P < 0.05). The scores of head and neck pain, pararthria, dysphagia, social difficulty, sensory difficulty, difficulty in feeding, xerostomia, cough, sticky saliva, and sensory discomfort during the radiation therapy were lower than those before radiation therapy (all P < 0.05). Except for the scores of sticky saliva and xerostomia, the other scores measured at 6 months after radiation therapy were all lower than those before radiation therapy, and the scores of dysphagia, sticky saliva, and xerostomia in MRT group were lower than those in CRT group (all P < 0.05). Conventional radiation therapy and intensity-modulated radiation therapy can cause a decline the quality of life for the patient with head and neck cancer, but intensity-modulated radiation therapy can improve local tumor control rate and significantly reduce the incidence of adverse reactions.

摘要

本研究旨在探讨调强放射治疗对鼻咽癌患者生活质量的影响,为临床实践提供理论依据和实践基础。本研究随机选取2007年9月至2012年8月在福建医科大学附属第二医院和重庆医科大学附属第一医院收治的130例不同分期的鼻咽癌患者,其中调强放射治疗(IMRT)组65例,接受调强放射治疗;常规放射治疗(CRT)组65例,接受常规放射治疗。根治性放射治疗靶区的处方剂量为72 Gy/36次;高危靶区的处方剂量为60 - 64 Gy/30 - 32次;低危靶区的处方剂量为50 - 54 Gy/25 - 27次,每次2 Gy,采用常规分割照射,每日1次,每周5次。通过填写问卷调查收集并分析接受调强放射治疗和常规放射治疗的鼻咽癌患者的生活质量数据,包括头颈癌生活质量问卷35(QLQ - H&N35)和简短健康调查问卷36(SF - 36)。SF - 36量表八个领域的RP、VT、BP、SF和RE评分在放射治疗期间下降,放射治疗后再次上升,放射治疗后6个月测量的评分高于放射治疗前(均P < 0.05)。放射治疗后2个月和6个月时IMRT组的评分均高于CRT组(均P < 0.05)。放射治疗期间头颈疼痛、言语障碍、吞咽困难、社交困难、感觉障碍、进食困难、口干、咳嗽、唾液黏稠和感觉不适的评分低于放射治疗前(均P < 0.05)。放射治疗后6个月时,除唾液黏稠和口干评分外,其他评分均低于放射治疗前,且IMRT组吞咽困难、唾液黏稠和口干的评分低于CRT组(均P < 0.05)。常规放射治疗和调强放射治疗均可导致头颈癌患者生活质量下降,但调强放射治疗可提高局部肿瘤控制率并显著降低不良反应发生率。

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