Pi G L, Bi J P, He H P, Li Y, Cheng T C, Li Y P
Head and Neck Radiotherapy Ward 1, Hubei Cancer Hospital, Wuhan, 430079, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Apr;32(8):617-620. doi: 10.13201/j.issn.1001-1781.2018.08.015.
To investigate the protective effect of optimized target delineation in intensity modulated radiation therapy(IMRT) on swallowing function in patients with different TNM staging of nasopharyngeal carcinoma.Fifty patients with nasopharyngeal carcinoma were enrolled in this study. They were randomly divided into 25 cases of experimental group and 25 cases of control group by random number table and received IMRT treatment. Patients in control group only received routine delineation of target areas, the patients in experimental group were given the delineation of the relevant parts of the swallowing on the basis of the control group.And then, the degree of dysphagia, xerostomia, weight loss, and quality of life were assessed in the two groups of patients during and after IMRT.There was no significant change in the degree of dysphagia in stage Ⅱ patients during radiotherapy, but the degree of dysphagia in stage Ⅲ and Ⅳ patients increased with the increase of radiotherapy time. After the end of radiotherapy, there was no significant change in the degree of dysphagia in the control group of patients. Compared with the 0th week after the end of radiotherapy, the stage Ⅱ patients in experimental group showed significant improvement in week 12(<0.05), while the stage Ⅲ and Ⅳ patients showed significant improvement in week 24 after radiotherapy(<0.05). The degree of xerostomia of two groups of patients continued to increase with varying degrees during and after IMRT(<0.05 or <0.01). The weight of the two groups of patients during radiotherapy continued to decrease with the increase of radiotherapy time,and gradually recovered after the end of radiotherapy.And in the experimental group, the weight loss was significantly lower in week 12 and week 24 than in the control group (<0.05). During radiotherapy, the quality of life scores of the two groups became lower and lower with the increase of radiotherapy time compared with the 0th week of radiotherapy. After the end of radiotherapy, the quality of life began to gradually improve, and in week 24 after the end of radiotherapy, the quality of life of the experimental group of patients was significantly higher than that of the control group (<0.05).During radiotherapy of patients with nasopharyngeal carcinoma, the structural organs associated with swallowing function are given individualized target delineation can reduce the occurring of dysphagia due to radiotherapy and improve the quality of life of patients after radiotherapy.
探讨调强放射治疗（IMRT）中优化靶区勾画对不同TNM分期鼻咽癌患者吞咽功能的保护作用。本研究纳入50例鼻咽癌患者。通过随机数字表将他们随机分为实验组25例和对照组25例，并接受IMRT治疗。对照组患者仅接受常规靶区勾画，实验组患者在对照组基础上进行吞咽相关部位的勾画。然后，在两组患者IMRT治疗期间及治疗后评估吞咽困难程度、口干程度、体重减轻情况及生活质量。Ⅱ期患者放疗期间吞咽困难程度无明显变化，但Ⅲ期和Ⅳ期患者吞咽困难程度随放疗时间延长而增加。放疗结束后，对照组患者吞咽困难程度无明显变化。与放疗结束后第0周相比，实验组Ⅱ期患者在第12周时吞咽困难程度有显著改善（<0.05），而Ⅲ期和Ⅳ期患者在放疗后第24周时有显著改善（<0.05）。两组患者口干程度在IMRT治疗期间及治疗后均有不同程度持续加重（<0.05或<0.01）。两组患者放疗期间体重随放疗时间延长持续下降，放疗结束后逐渐恢复。且实验组在第12周和第24周时体重减轻明显低于对照组（<0.05）。放疗期间，与放疗第0周相比，两组患者生活质量评分随放疗时间延长越来越低。放疗结束后，生活质量开始逐渐改善，放疗结束后第24周时，实验组患者生活质量显著高于对照组（<0.05）。鼻咽癌患者放疗期间，对与吞咽功能相关的结构器官进行个体化靶区勾画可减少放疗所致吞咽困难的发生，提高患者放疗后的生活质量。
