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題 名 | 不同方式放射線照射法對鼻咽癌病人唾液腺功能之影響=Effects of Different Radiation Therapy Schemes on the Salivary Flow Rate of NPC Patients |
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作 者 | 任益民; 林玉清; 王宜斌; 許文林; 吳錦榕; 黃經民; 熊佩韋; 張立平; 陳昌明; | 書刊名 | 放射治療與腫瘤學 |
卷 期 | 5:2 1998.06[民87.06] |
頁 次 | 頁65-71 |
分類號 | 416.36 |
關鍵詞 | 放射治療; 唾液; 鼻咽癌; Radiotherapy; Saliva; Nasopharyngeal carcinoma; |
語 文 | 英文(English) |
中文摘要 | 目的:研究鼻咽癌病人放射治療前後全唾液流量之變化,及檢驗多分次放射線照 射法,是否如理論所預期,可以降低放射治療對於唾液腺之傷害。 材料與方法:本研究一共對30例接受傳統照射與17例多分次照射之病人,定量地測量 鼻咽癌病人治療前、接受不同劑量照射後、及治療結束後一、三及六個月時,靜止態與刺激 態時唾液總流量的變化。 結果:發現正常未照射之唾液流量個別差異極大,靜止狀態範圍:0.01-0.83ml/min;刺激 狀態0.08-2.83ml/min。而且唾液腺對於放射線極度敏感,照射僅360-720cGy之後,靜止 狀態總唾液流量已減少50%,少數病人更已減少至原來之10%以下;而刺激狀態下的總流量, 也急劇降至原來的30-50%。而且在照射3600cGy之後,大部份病人唾液流量已達最低點。 至於使用多分次照射法是否較傳統照射法能減輕唾液腺之放射傷害,經以GEE之統計學分 析,發現基本上兩種照射法對於全唾液流量並無顯著差異,不過不論是靜止態或刺激態時, 在照射結束至半年期間,多分次照射法有較好之傾向(p值分別為0.039及0.04)。此外,分 析發現女性、未照射前之唾液流量高、以及年齡越大者,唾液腺經照射後其流量減少越明顯。 結論:本研究首度就國人唾液流量之正常值堤出具體數據,發現個別差異極大。唾液腺 對於放射線極度敏感,照射僮360-720cGy之後,靜止與刺激狀態總唾液流量已減少30-50%。 照射3600cGy之後,大部份病人唾液流量已達最低點,且直到照射結束後六個月均不見恢復。 使用多分次照射法,在唾液腺傷害方面,似未比傳統照射法好。 |
英文摘要 | Purpose: To evaluate the change of whole salivary flow rates of nasopharyngeal carcinoma patients before and after radiotherapy, and to examine whether hyper-fractionated regimen may induce less damage to the salivary glands than conventional technique. Materials and Methods: This study included 30 and 17 patients irradiated using conventional and hyper-fractionated radiotherapy. Whole salivary flow rates were measured both at resting and stimulated status before, during, 1, 3 and 6 months after radiotherapy. Results: A large variation in unirradiated salivary flow rate was noted with the range for resting and stimulated rates of 0.01-0.83 ml/min and 0.08-2.83 ml/min, respectively. After 360-720 cGy, the resting and stimulated salivary flow rate had already decreased by 30-50%. The nadir was reached in many patients after 3600 cGy. Statistical analysis did not show significant difference between the hyper- fractionated and conventional groups. However, after completing radiotherapy and up to 6 months' follow-up, a marginal difference favoring hyper-fractionated group was noted both for resting and stimulated flow (p=0.039 & 0.04, respectively). In addition, female, high initial salivary flow rate, and older age might predict more salivary flow rate reduction after radiotherapy. Conclusions: Salivary glands were highly radiosensitive, and saliva excretion dropped by 30-50% after 360-720 cGy. The present study did not show a significant reduction of damage to the salivary glands using hyper-fractionated radiotherapy. |
本系統中英文摘要資訊取自各篇刊載內容。