放疗中累积辐射剂量与头颈部癌症重度口腔黏膜炎发生率的关系。

The association between cumulative radiation dose and the incidence of severe oral mucositis in head and neck cancers during radiotherapy.

机构信息

Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan.

Department of Pharmacy, Showa University Fujigaoka Hospital, Yokohama, Japan.

出版信息

Cancer Rep (Hoboken). 2021 Apr;4(2):e1317. doi: 10.1002/cnr2.1317. Epub 2020 Dec 9.

DOI:10.1002/cnr2.1317

PMID:33295153

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8451373/

Abstract

BACKGROUND

Quality of life can be influenced by oral mucositis (OM), and it is necessary to implement OM management strategies before the initiation of radiotherapy (RT) in patients with head and neck cancer (HNC).

AIMS

To examine the association between the cumulative radiation dose and the incidence of severe OM in HNC patients receiving RT.

METHODS AND RESULTS

A retrospective observational cohort study was conducted in a Showa University Fujigaoka Hospital, in Japan. We retrospectively analyzed 94 patients with HNC who developed OM during RT. We defined OM as a more than grade 2 OM. The cumulative incidence of OM curves of the two categories was estimated using the Kaplan-Meier method and compared using the log-rank test. We estimated the hazard ratio (HR) for OM after the adjustment of factors for covariates using Cox's regression analysis. Patients with smoking history had a significantly later development of OM than those with no smoking history (20 Gy-incidence OM 68.7% vs 39.7%, P = .003). In contrast, patients undergoing concurrent chemotherapy had an earlier development of OM than those undergoing RT alone (20 Gy-incidence OM 24.2% vs 55.7%, P < .001). Multivariate analysis revealed that no smoking history and concurrent chemotherapy were independent predictive factors, with a HR of 0.526 (P = .025) and 2.690 (P < .001), respectively.

CONCLUSION

We demonstrated that no smoking history and concurrent chemotherapy may be predictive of OM in HNC patients.

摘要

背景

生活质量可能会受到口腔黏膜炎（OM）的影响，因此有必要在头颈部癌症（HNC）患者开始放疗（RT）之前实施 OM 管理策略。

目的

探讨接受 RT 的 HNC 患者累积放射剂量与重度 OM 发生率之间的关系。

方法和结果

本研究是在日本昭和大学藤冈医院进行的回顾性观察队列研究。我们回顾性分析了 94 例在 RT 期间发生 OM 的 HNC 患者。我们将 OM 定义为 2 级以上的 OM。使用 Kaplan-Meier 法估计两种分类的 OM 累积发生率曲线，并使用对数秩检验进行比较。使用 Cox 回归分析对调整了协变量因素后的 OM 发生风险比（HR）进行了估计。有吸烟史的患者 OM 发生时间明显晚于无吸烟史的患者（20 Gy 发生率 OM 为 68.7% vs. 39.7%，P =.003）。相反，同时接受化疗的患者 OM 发生时间早于单独接受 RT 的患者（20 Gy 发生率 OM 为 24.2% vs. 55.7%，P <.001）。多变量分析显示，无吸烟史和同期化疗是独立的预测因素，HR 分别为 0.526（P =.025）和 2.690（P <.001）。