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在相应的时间窗口内为鼻咽癌患者安排放射治疗可以减少放射性口腔黏膜炎:一项随机、前瞻性研究。

Scheduling radiotherapy for patients with nasopharyngeal carcinoma in the corresponding time window can reduce radiation-induced oral mucositis: A randomized, prospective study.

机构信息

Department of Radiotherapy, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.

出版信息

Cancer Med. 2023 Aug;12(15):16032-16040. doi: 10.1002/cam4.6252. Epub 2023 Aug 3.

Abstract

BACKGROUND

To explore a new method to reduce radiation-induced oral mucositis by scheduling radiotherapy for patients with nasopharyngeal carcinoma (NPC) in the corresponding time window of the cycle of oral mucosal cells.

METHODS

Eighty-two NPC patients were randomly divided into a day group (n = 41) and a night group (n = 41). The radiotherapy was scheduled at noon (11:30-15:30) for the day group, while at night (19:00-23:00) for the night group. Oral mucositis and oral pain were recorded in both groups after each radiotherapy fraction. The short-term efficacy of primary tumor regression, weight loss, and bone marrow suppression was recorded.

RESULTS

The incidence of Grade 2 oral mucositis was 87.8% (36/41) and 63.4% (26/41) in the night group and day group, respectively (p = 0.010). The incidence of Grade 3 oral mucositis was 65.9% (27/41) and 22.0% (9/41) in the night group and day group, respectively (p < 0.001). The mean number of radiotherapy for patients to develop Grade 2 oral mucositis was 15.67 ± 5.05 and 20.92 ± 6.21 in the night group and day group, respectively. The incidence of Grade 2 oral pain was 48.8% (20/41) and 22.0% (9/41) in the night group and day group, respectively (p = 0.011). There were no significant differences in tumor regression, weight loss, and bone marrow suppression between the two groups.

CONCLUSION

By scheduling radiotherapy based on the corresponding time window of the cycle of oral mucosal cells, the severity of oral mucositis in NPC patients was reduced.

摘要

背景

为了通过将鼻咽癌(NPC)患者的放射治疗安排在口腔黏膜细胞周期的相应时间窗内,探索一种减轻放射性口腔黏膜炎的新方法。

方法

将 82 例 NPC 患者随机分为日间组(n=41)和夜间组(n=41)。日间组的放疗安排在中午(11:30-15:30),夜间组则在晚上(19:00-23:00)。两组患者在每次放疗后均记录口腔黏膜炎和口腔疼痛情况。记录原发肿瘤消退、体重减轻和骨髓抑制的短期疗效。

结果

夜间组和日间组中,2 级口腔黏膜炎的发生率分别为 87.8%(36/41)和 63.4%(26/41)(p=0.010)。3 级口腔黏膜炎的发生率分别为 65.9%(27/41)和 22.0%(9/41)(p<0.001)。夜间组和日间组中,患者发生 2 级口腔黏膜炎所需的平均放疗次数分别为 15.67±5.05 和 20.92±6.21。夜间组和日间组中,2 级口腔疼痛的发生率分别为 48.8%(20/41)和 22.0%(9/41)(p=0.011)。两组之间在肿瘤消退、体重减轻和骨髓抑制方面无显著差异。

结论

通过根据口腔黏膜细胞周期的相应时间窗安排放射治疗,可以减轻 NPC 患者口腔黏膜炎的严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2da0/10469752/6e8c8ecd6a19/CAM4-12-16032-g001.jpg

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