| 张羽,曲颂,李龄,赵伟,裴苏,陈晓倩,梁忠国,梁振强,朱小东.鼻咽癌调强放疗致急性放射性口干的剂量学研究[J].中华放射医学与防护杂志,2015,35(10):745-750 |
| 鼻咽癌调强放疗致急性放射性口干的剂量学研究 |
| Acute xerostomia and dosmimetric study in nasopharyngeal carcinoma patients |
| 投稿时间：2015-03-04 |
| DOI：10.3760/cma.j.issn.0254-5098.2015.10.006 |
| 中文关键词: 口干 放疗 涎腺 鼻咽癌 |
| 英文关键词:Xerostomia Radiotherapy Salivary gland Nasopharyngeal carcinoma |
| 基金项目:广西自然科学基金(桂科基0575090);广西医疗卫生重点科研项目(厅重200969);广西医疗卫生适宜技术研究与开发项目(S201417-04)。 |
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| 中文摘要: |
| 目的 探讨鼻咽癌调强放疗所致急性放射性口干与放疗剂量的关系。方法 收集2013年12月至2014年7月接受调强放疗的109例鼻咽癌患者,分析患者的一般临床资料及双侧腮腺、双侧下颌下腺、双侧涎腺(双侧腮腺+双侧下颌下腺)的照射剂量等数据。在放疗结束时根据口干程度把患者分为非重度口干组(57例)和重度口干组(52例),并对两组之间的一般资料以及相关的剂量学因素进行比较分析。记录双侧腮腺接受15~50 Gy照射剂量的体积百分比,采用Logistic多因素回归法分析急性重度口干的独立预测因子,并用受试者工作特征曲线(ROC)分析其诊断界值点。结果 至放疗结束,所有入组患者重度口干的发生率为47.7%(52/109)。临床因素的分析提示年龄、黏膜炎、化疗方式均与急性重度放射性口干的发生无关。非重度口干组和重度口干组剂量学指标比较的结果显示,两组平均剂量差异均有统计学意义(t=-6.179、-6.055、-2.293,P<0.05)。Logistic回归分析显示,V34是判断急性重度放射性口干的独立预测因素。V34的ROC曲线表明:V34=49%对重度放射性口干预测的敏感度和特异度分别为71.2%和75.4% (OR=1.231,P<0.05,95%CI:1.116~1.357)。结论 在鼻咽癌调强放疗计划中,双侧腮腺的V34是重度急性放射性口干的独立预测因子,可以作为评估发生急性重度放射性口干发生风险的剂量学指标。 |
| 英文摘要: |
| Objective To evaluate the relationship between radiation-induced acute xerostomia and the dosimetric factor changes of the parotid and submandibular glands. Methods A total of 109 nasopharyngeal carcinoma (NPC) patients who underwent IMRT were included. They were divided into two groups according to the severity of xerostomia: severe(52) and non-severe(57) mucositis groups. Several clinical factors including age, and chemotherapy were analyzed by chi-square test. The delivered doses as well as the volumes of the parotid and submandibular were also collected. The t-test was used to compare the differences between the two groups. The dosimetric factors(V15-V50)of the parotid glands were analyzed by Binary Logistic regression (Forward-conditional method). Results The incidence of severe acute xerostomia was 47.7%(52/109). There was no statistical difference between severe acute xerostomia and several clinical factors, which included age,mucositis and chemotherapy. The mean radiation doses of the glands between the severe and non-severe xerostomia group were statistically significant(t=-6.179,-6.055,-2.293,P<0.05). Logistic regression of the parotid gland showed that V34 was an independent indicating factor of severe acute xerostomia. When using V34=49% as a cut-off to predict severe xerostomia, the sensitivity and specificity were 71.2% and 75.4%, respectively(OR=1.231, P<0.05,95%CI:1.116-1.357). Conclusions The study evaluated the delivered doses of the parotid and submandibular glands and their relationship with acute xerostomia.V34 was a valuable indicator for predicting severe acute xerostomia. |
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