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头颈部癌症患者急性吞咽困难与治疗耐受性的咽鼓管腺剂量前瞻性评估。

A Prospective Evaluation of Tubarial Gland Doses With Acute Dysphagia and Treatment Tolerance in Head and Neck Cancer Patients.

作者信息

Aral İpek Pınar, Altinisik Inan Gonca, Dadak Binnur, Görtan Fatma Arzu, Tezcan Yılmaz

机构信息

Radiation Oncology, Ankara Yıldırım Beyazıt University, Ankara, TUR.

Radiation Oncology, Ankara Bilkent City Hospital, Ankara, TUR.

出版信息

Cureus. 2024 Mar 20;16(3):e56566. doi: 10.7759/cureus.56566. eCollection 2024 Mar.

Abstract

Background This study prospectively analyzed the clinical significance of tubarial glands (TGs) doses in head and neck cancer (HNC) patients. Methods Patients diagnosed with HNC in Ankara Bilkent City Hospital, Turkey were analyzed. TGs volumes and doses were noted. The patients were evaluated in terms of acute dysphagia (AD) and radiation therapy (RT)-associated xerostomia. Results The median volume of the TGs was 3.5(2.1-5.9)cc. No increased standardized uptake values (SUV) were observed in the TGs. There was no significant relationship between TGs values and the third or sixth months of xerostomia after RT. There was a significant relationship between grade ≥2 AD and TGs-D (p0.020); TGs-V(p0.007); TGs-V(p0.009); TGs-V(p0.011); TGs-V(p0.010), TGs-V(p0.045). In terms of the risk of grade ≥2 AD, the cut-off value of the TGs-D was analyzed for 50 Gy, with 75% sensitivity and 73.3% specificity (p 0.020; AUC 0.746; 95% CI 0.561-0.929). Additionally for grade ≥2 AD, the cut-off value of the TGs-Vwas analyzed 78 with 81.3% sensitivity and 80.0% specificity (p 0.011; AUC 0.769; 95% CI 0.591-0.947). Conclusion A significant correlation was found between TGs doses and AD during RT. TGs-Vvalue showed higher significance. In future studies, the clinical significance of TGs can be studied especially on this value. The relationship between TGs doses and xerostomia should be evaluated with a larger series.

摘要

背景 本研究前瞻性分析了头颈部癌(HNC)患者咽鼓管腺(TGs)剂量的临床意义。方法 对土耳其安卡拉比尔肯特市医院诊断为HNC的患者进行分析。记录TGs体积和剂量。对患者进行急性吞咽困难(AD)和放射治疗(RT)相关口干的评估。结果 TGs的中位体积为3.5(2.1 - 5.9)立方厘米。TGs中未观察到标准化摄取值(SUV)增加。TGs值与RT后口干的第三个月或第六个月之间无显著关系。≥2级AD与TGs-D(p = 0.020)、TGs-V(p = 0.007)、TGs-V(p = 0.009)、TGs-V(p = 0.011)、TGs-V(p = 0.010)、TGs-V(p = 0.045)之间存在显著关系。就≥2级AD的风险而言,分析了TGs-D的截断值为50 Gy,敏感性为75%,特异性为73.3%(p = 0.020;AUC = 0.746;95% CI = 0.561 - 0.929)。此外,对于≥2级AD,分析了TGs-V的截断值为78,敏感性为81.3%,特异性为80.0%(p = 0.011;AUC = 0.769;95% CI = 0.591 - 0.947)。结论 发现TGs剂量与RT期间的AD之间存在显著相关性。TGs-V值显示出更高的显著性。在未来的研究中,尤其可以基于该值研究TGs的临床意义。应通过更大样本量评估TGs剂量与口干之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52da/11029817/f106da5d7927/cureus-0016-00000056566-i01.jpg

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