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门诊唾液腺导管类固醇冲洗治疗头颈部癌患者放疗后口干症的疗效:一项回顾性研究

Efficacy of Office-Based Salivary Ductal Steroid Irrigation for Managing Post-Irradiation Xerostomia in Head and Neck Cancer Patients: A Retrospective Study.

作者信息

Chen Yen-Chun, Viet-Nhi Nguyen-Kieu, Dang Luong Huu, Su Chin-Hui, Hung Shih-Han

机构信息

Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan.

Department of Otolaryngology, Taipei Medical University Hospital, Taipei 110301, Taiwan.

出版信息

Biomedicines. 2024 May 8;12(5):1033. doi: 10.3390/biomedicines12051033.

Abstract

Post-irradiation xerostomia remains a significant quality of life concern for patients with head and neck cancers. Conventional therapies offer limited effectiveness. This study aims to investigate the therapeutic potential of office-based salivary ductal steroid irrigation in patients with post-irradiation xerostomia. This single-center observational study recruited 147 head and neck cancer patients suffering from post-irradiation xerostomia between November 2020 and October 2022. All included subjects received at least one round of successful salivary ductal cannulation and irrigation. The primary measure of efficacy was improvement in subjective xerostomia and objective salivary amylase levels. A logistic regression was employed to evaluate factors affecting treatment responsiveness. The response rate among nasopharyngeal cancer (NPC) patients was 74.8%, and that among non-NPC cancer was 65.6%, without significant intergroup differences. The statistical analysis revealed no significant influence of age, gender, or disease stage on treatment responsiveness. Post-treatment salivary amylase levels were significantly higher in responsive non-NPC patients. In conclusion, salivary ductal steroid irrigation emerged as a promising therapeutic modality for the management of post-irradiation xerostomia in head and neck cancer patients. While no explicit factors were predictive of responsiveness, the high rate of symptom improvement suggests that this therapy may be a viable alternative for patients that are refractory to standard treatments.

摘要

放疗后口干仍然是头颈癌患者生活质量的一个重大问题。传统疗法效果有限。本研究旨在探讨门诊唾液腺导管类固醇冲洗术对放疗后口干患者的治疗潜力。这项单中心观察性研究在2020年11月至2022年10月期间招募了147名头颈癌放疗后口干患者。所有纳入的受试者均接受了至少一轮成功的唾液腺导管插管和冲洗。疗效的主要衡量指标是主观口干的改善和客观唾液淀粉酶水平。采用逻辑回归分析评估影响治疗反应性的因素。鼻咽癌(NPC)患者的有效率为74.8%,非NPC癌症患者的有效率为65.6%,组间差异无统计学意义。统计分析显示,年龄、性别或疾病分期对治疗反应性无显著影响。有反应的非NPC患者治疗后的唾液淀粉酶水平显著升高。总之,唾液腺导管类固醇冲洗术是治疗头颈癌患者放疗后口干的一种有前景的治疗方式。虽然没有明确的因素可预测反应性,但症状改善率较高表明,对于标准治疗无效的患者,这种疗法可能是一种可行的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d231/11117565/6a57a859bd72/biomedicines-12-01033-g001.jpg

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