头颈部放疗后出现严重的口干、吞咽困难和颈部纤维化。
Very late xerostomia, dysphagia, and neck fibrosis after head and neck radiotherapy.
机构信息
Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium.
Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University, Ghent, Belgium.
出版信息
Head Neck. 2019 Oct;41(10):3594-3603. doi: 10.1002/hed.25880. Epub 2019 Jul 22.
BACKGROUND
Acute and late toxicity after intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC) impacts on patient quality of life; yet, very late toxicity data remain scarce. This study assessed dysphagia, xerostomia, and neck fibrosis 3-8 years after IMRT.
METHODS
A retrospective analysis using generalized estimated equations was performed on 60 patients with HNC treated with fractionated IMRT between 2000 and 2015 who had a follow-up ≥8 years. Toxicity was scored using LENT-SOMA scales.
RESULTS
A trend towards a nonlinear global time effect (P = .05) was noted for dysphagia with a decrease during the 5 years post-treatment and an increase thereafter. A significant decrease in xerostomia (P = .001) and an increase in neck fibrosis (P = .04) was observed until 8 years.
CONCLUSIONS
Dysphagia, xerostomia, and neck fibrosis do not appear stable over time and remain highly prevalent in the very late follow-up. Our findings support the need for prospective trials investigating very late toxicity in patients with HNC.
背景
头颈部癌症（HNC）调强放疗（IMRT）后的急性和晚期毒性会影响患者的生活质量；然而，非常晚期的毒性数据仍然很少。本研究评估了 IMRT 治疗后 3-8 年的吞咽困难、口干和颈部纤维化。
方法
对 2000 年至 2015 年间接受分割 IMRT 治疗的 60 例 HNC 患者进行了回顾性分析，这些患者的随访时间≥8 年。采用 LENT-SOMA 量表对毒性进行评分。
结果
吞咽困难的整体时间效应呈非线性趋势（P =.05），治疗后 5 年内下降，此后上升。观察到口干（P =.001）显著下降和颈部纤维化（P =.04）增加，直到 8 年。
结论
吞咽困难、口干和颈部纤维化随时间推移似乎并不稳定，在非常晚期随访中仍高度普遍。我们的研究结果支持需要进行前瞻性试验，以研究 HNC 患者的非常晚期毒性。
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