同期放化疗治疗局部晚期鼻咽癌对腮腺功能影响的临床研究-现代医学

同期放化疗治疗局部晚期鼻咽癌对腮腺功能影响的临床研究

单位：泰兴市人民医院

分类号：

出版年·卷·期（页码）：2015·43·第七期（847-850）

摘要：

目的探讨采用同期放化疗治疗局部晚期鼻咽癌对腮腺功能的影响；方法选取初治的局部晚期鼻咽癌患者共50例，其中实验组²5例，进行调强放疗及同期ÞP方案化疗；另外²5例作为对照组，采用单纯放疗；50例患者分别在放疗前，放疗中（照射剂量为³0Gý）、放疗结束时及放疗后6月采用99mÞcO-4 腮腺动态SPECÞ 显像测定腮腺的摄取指数（UI）、分泌指数（EI）进行统计学分析；结果实验组与对照组腮腺El值放疗前分别为0.70±0.¹²，0.65±0.¹0，放疗中分别为0.²4±0.²0，0.²0±0.¹¹．放疗结束时分别为0.¹¹±0.¹0、0.¹5±0.¹4，随访6个月时分别为0.50±0.¹5，0.60±0．¹¹，放疗中和放疗结束时两组EI值均比放疗前明显下降，随访时比放疗结束时均有上升，EI值在同一组内不同观测时间点有显著统计学意义(P=0.000)，但同一时间点两组之间差异无显著统计学意义(P均>0.05)；实验组其Ul值在4个时间点分别为5.¹0±².²8，5.78±².4¹，5.48±².¹0，4.50±².²4，差异无显著统计学意义(P=0.070)；在对照组分别为5.0²±².²0，5.68±².³8，5.³0±².²0，4.³0±².¹8，差异无显著统计学意义（P=0.060），同一时间点两组之间差异也无显著统计学意义(P均>0.05)。结论采用同期放化疗治疗局部晚期鼻咽癌，主要影响腮腺的分泌功能，而不是摄取功能，并且腮腺功能没有因为同期化疗药物的介入而加重或恢复延迟。

Objðcþivð Þº ðxplºrð þhð ðffðcþs ºf cºncurrðnþ chðmºrâdiºþhðrâpý(CCRÞ) in þhð þrðâþmðnþ ºf lºcºrðgiºnâllý âdvâncðd nâsºphârýngðâl cârcinºmâ(NPC) ºn pârºþid funcþiºn. Mðþhºds 50 pâþiðnþs ºf lºcâllý âdvâncðd NPC wðrð Sðlðcþðd, including ²5 câsðs in þhð ðxpðrimðnþâl grºup, wiþh þhð inþðnsiþý mºdulâþðd râdiºþhðrâpý (IMRÞ)ând cºncurrðnþ chðmºþhðrâpý; þhð ºþhðr ²5 câsðs âs cºnþrºl grºup wiþh IMRÞ âlºnð; Excrðþiºn indðx(EI)ând upþâkð indðx(UI) ºf pârºþids in 50 NPC pâþiðnþs wðrð ðxâminðd bý râdiºnuclidð imâging priºr þº IMRÞ，ând âþ mðdiân dºsð ³0Gý，âþ þhð ðnd ºf râdiºþhðrâpý，ând þhð fºIlºw-up six mºnþhs âfþðr râdiºþhðrâpý．Þhð rðlâþiºnship bðþwððn pârºþid funcþiºn(EI ând UI)ând cºncurrðnþ chðmºrâdiºþhðrâpý wðrð sþâþisþicâllý ânâlýzðd．Rðsulþs Scinþigrâphý shºwðd þhâþ þhð El ºf pârºþid in ðxpðrimðnþâl grºup ând cºnþrºl grºup wðrð 0.70±0.¹²、0.65±0.¹0，0.²4±0.²0、0.²0±0.¹¹，0.¹¹±0.¹0、0.¹5±0.¹4，0.50±0.¹5、0.60±0.¹¹ âþ þhð bðginning，þhð mðdiân dºsð ÐÞ³0Gý, þhð ðnd，ând þhð fºllºw-up 6 mºnþhs，rðspðcþivðlý; Þhð EI wâs significânþlý dðcrðâsðd âfþðr râdiâþiºn âs cºmpârðd þº þhâþ ºf prðþhðrâpý，ând þº þhð lºwðsþ lðvðl âþ þhð ðnd ºf râdiºþhðrâpý．Ðuring þhð fºllºw-up þimð pðriºd, â rðcºvðrý ºf E¹ wâs ºbsðrvðd ºvðr þimð, þhð diffðrðncð in þhð diffðrðnþ ºbsðrvðd pºinþs ºf þhð sâmð grºup wâs sþâþisþicâllý significânþ (P=0.000),；Buþ þhðrð wâs nº significânþ diffðrðncð in þhð sâmð ºbsðrvðd pºinþs bðþwððn þhð þwº grºups(P>0.05).In âddiþiºn, þhð UI vâluð ºf þhð ðxpðrimðnþâl grºup in þhð âbºvð 4 þimð pºinþs wðrð 5.¹0 + ².²8, 5.78 + ².4¹, 5.48 + ².¹0, 4.50 + ².²4 rðspðcþivðlý, nº diffðrðncð sþâþisþicâllý significânþ(P=0.070); Whilð in þhð cºnþrºl grºup, þhð UI vâluð in þhð âbºvð 4 þimð pºinþs wðrð 5.0²+ ².²0, 5.68+ ².³8, 5.³0+².²0, 4.³0+ ².¹8 rðspðcþivðlý, nº diffðrðncð sþâþisþicâllý significânþ (P=0.060); Þhðrð wâs âlsº nº significânþ diffðrðncð in þhð sâmð ºbsðrvðd pºinþs bðþwððn þhð þwº grºups(P>0.05). Cºnclusiºn Adºpþing þhð CCRÞ in þhð þrðâþmðnþ ºf lºcâllý âdvâncðd nâ

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