Lan Xinmiao, Chan Jason Y K, Pu Jingya Jane, Qiao Wei, Pang Siling, Yang Wei-Fa, Wong Kenneth C W, Kwong Dora L W, Su Yu-Xiong
Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
Department of Otorhinolaryngology-Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
Radiother Oncol. 2020 Sep;150:97-103. doi: 10.1016/j.radonc.2020.06.016. Epub 2020 Jun 13.
Nasopharyngeal carcinoma (NPC) is one of the most common cancers in southern China and the first-line treatment is radiotherapy. Intensity-modulated radiation therapy (IMRT) can deliver high dose to cancer and low dose to normal tissue, but xerostomia is still one of the complications after IMRT. However, how the concentration of saliva electrolytes be affected by IMRT and the effects on the quality of life are still unknown. In this prospective study, 76 NPC patients were recruited from hospitals in Hong Kong to identify the change of saliva electrolytes and xerostomia-related quality of life before and after IMRT.
Saliva and questionnaire were collected before IMRT, 1 month, 3 months, 6 months and 12 months after IMRT. The concentration of saliva electrolytes was detected using inductively coupled plasma-optical emission spectroscopy (ICP-OES).
Saliva flow rate significantly decreased after IMRT. Decrease in the mean value of pH was observed but the difference is not statistically significant. The concentrations of potassium, iodine, and calcium decreased and chloride concentration increased after IMRT, while the concentrations of sodium, magnesium, copper or zinc were kept at the same level before and after treatment. Xerostomia-related quality of life was adversely affected by IMRT, but partially recovered after 1 year.
Our study revealed the change of saliva electrolytes and xerostomia-related quality of life in patients undergone IMRT for NPC.
鼻咽癌(NPC)是中国南方最常见的癌症之一,一线治疗方法是放射治疗。调强放射治疗(IMRT)可使肿瘤接受高剂量照射,同时减少正常组织受照剂量,但口干仍是IMRT后的并发症之一。然而,IMRT如何影响唾液电解质浓度及其对生活质量的影响仍不清楚。在这项前瞻性研究中,从香港的医院招募了76例鼻咽癌患者,以确定IMRT前后唾液电解质的变化以及与口干相关的生活质量。
在IMRT前、IMRT后1个月、3个月、6个月和12个月收集唾液和问卷。采用电感耦合等离子体发射光谱法(ICP-OES)检测唾液电解质浓度。
IMRT后唾液流速显著降低。观察到pH平均值下降,但差异无统计学意义。IMRT后钾、碘和钙的浓度降低,氯浓度升高,而钠、镁、铜或锌的浓度在治疗前后保持在同一水平。与口干相关的生活质量受到IMRT的不利影响,但1年后部分恢复。
我们的研究揭示了接受IMRT治疗的鼻咽癌患者唾液电解质和与口干相关的生活质量的变化。