摘要
目的分析局部晚期下咽及喉部鳞癌(locally advanced squamous cell carcinoma of the hypopharynx and larynx,LA-SCCH/L)行调强放疗剂量学因素与急性口腔黏膜炎的关系。方法 2008年8月1日-2014年12月31日本院共收治80例非手术LA-SCCH/L患者,行螺旋断层放疗(Hi-Art tomotherapy,HT)或容积旋转调强放疗(Varian Rapid Arc,RA),并在放疗期间行含顺铂方案的化疗。采用受试者工作特征曲线(receive operating characteristic,ROC)寻找急性口腔黏膜炎剂量学相关指标的界值。结果 HT和RA口腔黏膜炎发生率无统计学差异。多因素分析显示,口腔V_(30)是发生≥2级口腔黏膜炎的独立影响因子(P=0.035);口腔V_(30)≥42.4%患者中≥2级口腔黏膜炎发生率为75.0%(18/24),而在V_(30)<42.4%患者中则只有35.7%(20/56)。结论螺旋断层放疗与容积旋转调强放疗的急性不良反应无显著差异。口腔V_(30)与急性放射性口腔黏膜炎相关。
Objective To evaluate the correlation between acute oral mucositis and dosimetric factors in intensity-modulated radiotherapy（IMRI） in locally advanced squamous cell carcinoma of hypopharynx and larynx（LA-SCCH/L）. Methods From August 1, 2008 to December 31, 2014, 80 patients with LA-SCCH/L were treated by helical tomotherapy（HT） or Rapid Arc unit（RA）, combined with concurrent cisplatin-based chemotherapy in our hospital. The related dosimetric factors were analyzed by receive operating characteristic（ROC） curve to detect the cutoff value of risk factors for the acute oral mucositis. Results No significant difference was found in the incidence of acute oral mucositis between HT and RA. Logistic analysis showed that oral V_（30） was independently associated with ≥ G2 mucositis（P = 0.035） with a cut-off value of 42.4% detected by ROC analysis. The incidence of ≥ G2 oral mucositis was 75%（18/24） in patients with oral V_（30） ≥ 42.4%, and it was only 35.7% in patients with oral V_（30）42.4%（20/56）. Conclusion In the treatment of LA-SCCH/L, HT and RA are effective in protecting the normal tissues, without significant difference in acute oral mucositis. Oral V_（30） is related to acute oral mucositis.
作者
蔡博宁
戴相昆
徐寿平
陈高翔
宋明永
马林
CAI Boning DAI Xiangkun XU Shouping CHEN Gaoxiang SONG Mingyong MA Lin(Department of Radiotherapy, Chinese PLA General Hospital, Beijing 100853, China)
出处
《解放军医学院学报》
CAS
2016年第12期1219-1222,共4页
Academic Journal of Chinese PLA Medical School
基金
国家自然科学基金项目(11105225)
解放军总医院临床科研扶持基金(2015FC-TSYS-2001)~~
