| 黄思思,文恩,姜军红.沙利度胺防治头颈部肿瘤放射性口腔黏膜炎 37例[J].安徽医药,2023,27(11):2296-2300. |
| 沙利度胺防治头颈部肿瘤放射性口腔黏膜炎 37例 |
| Thalidomide in the prevention and treatment of radiooral mucositis of head and neck cancer:37 cases |
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| DOI：10.3969/j.issn.1009-6469.2023.11.040 |
| 中文关键词: 沙利度胺 放射治疗 头颈部肿瘤 急性放射性口腔黏膜炎 |
| 英文关键词: Thalidomide Radiotherapy Head and neck cancer Radiation-induced oral mucositis |
| 基金项目:内江市科技计划项目( Z202079) |
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| 中文摘要: |
| 目的观察沙利度胺防治头颈部肿瘤急性放射性口腔黏膜炎( RIOM)的临床疗效。方法选取 2020年 8月至 2021年 8月内江市第一人民医院接受头颈部放疗的恶性肿瘤病人 75例，采用随机数字表法分为观察组和对照组。观察组 37例口服沙利度胺 100~150 mg(70 mg·m-2·d-1)，同时给予 0.9%氯化钠注射液( 50 mL)+利多卡因(0.1 g)+庆大霉素( 8万单位) +地塞米松(10 mg)漱口，对照组 38例仅用同样的 0.9%氯化钠注射液( 50 mL)+利多卡因( 0.1 g)+庆大霉素( 8万单位) +地塞米松( 10 mg)漱口。根据肿瘤分期，若需行同步化疗，放疗期间每周给予顺铂 40 mg/m2。观察两组放射性口腔黏膜炎的发生时间、严重程度、生活质量以及沙利度胺治疗的安全性。结果观察组和对照组全部发生放射性口腔黏膜炎，其中观察组 1~4级 RIOM发生率分别为 13.5%、45.9%、35.1%、5.4%，对照组 1~4级 RIOM分别为 2.6%、23.7%、57.9%、15.8%，两组在 2级、 3级、 ≥3级 RIOM发生率差异有统计学意义( P<0.05)。观察组平均发生时间为 15.8 d，对照组发生时间为 10.1 d，两组发生时间差异有统计学意义(P<0.001)。观察组放疗后最低 KPS评分平均为 82分，对照组放疗后最低 KPS评分平均为 78分，观察组放疗后生活质量优于对照组( P=0.015)。两组在性别、年龄、是否化疗、剂量学参数方面差异无统计学意义( P>0.05)；两组在血液学毒性、周围神经毒性、肝肾功能损害、胃肠道反应方面差异无统计学意义( P>0.05)。结论沙利度胺有助于减轻 RIOM的严重程度，推迟 RIOM发生时间，改善病人放疗后生活质量，且不明显增加不良反应，可作为预防和治疗 RIOM的辅助用药。 |
| 英文摘要: |
| Objective To observe the clinical efficacy of thalidomide in treating acute radiation-induced oral mucositis (RIOM) of head and neck tumor. Methods Seventy-five patients with malignant tumors who received head and neck radiotherapy in NeijiangFirst People′s Hospital from August 2020 to August 2021 were selected and assigned into observation group and control group by ranm-2dom number table method. In the observation group, 37 patients were orally given thalidomide 100-150 mg (70 mg··d-1), and at thesame time, they were given saline (50 mL) + lidocaine (0.1 g) + gentamicin (80 000 units) + dexamethasone (10 mg). In the controlgroup, 38 cases were gargled with the same saline (50 mL) + lidocaine (0.1 g) + gentamicin (80 000 units) + dexamethasone (10 mg).According to tumor stage, if synchronous chemotherapy is needed, cisplatin is given 40 mg/m2 per week during radiotherapy. The occurrence time, severity, quality of life and safety of thalidomide treatment of oral mucositis in the two groups were observed.Results All oral mucositis occurred in the observation group and the control group. The incidence of grade 1 to 4 RIOM in the treatment group was13.5%, 45.9%, 35.1% and 5.4%, respectively. The incidence of grade 1 to 4 RIOM in the control group was 2.6%, 23.7%, 57.9% and15.8%, respectively. There were significant differences in the incidence of grade 2, 3 and ≥3 RIOM between the two group (P<0.05).The mean time of occurrence in the observation group and the control group was 15.8 days and 10.1 days, respectively, and the difference between the two groups was statistically significant (P<0.001). The average lowest KPS score after radiotherapy in the observationgroup and the control group was 82 and 78, respectively. The quality of life after radiotherapy in the observation group was better thanthat in the control group (P=0.015). There were no significant differences in gender, age, chemotherapy and dosimetry parameters between the two groups (P>0.05). There were no significant differences between the two groups in hematological toxicity, peripheral neurotoxicity, liver and kidney function impairment and gastrointestinal reaction (P>0.05).Conclusion Thalidomide is helpful to reduce theseverity of RIOM, delay the onset time of RIOM, improve the quality of life of patients after radiotherapy, and does not increase adversereactions, and can be used as an adjunct to prevent and treat RIOM. |
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