鼻咽癌放疗中放射性干眼症的临床观察

发布时间：2018-06-27 05:45

本文选题：放射性干眼症 + 鼻咽癌病人　；参考：《广西医科大学》2016年硕士论文

【摘要】：目的：探讨鼻咽癌病人放射性干眼症的发生与患者年龄、剂量、治疗方式的相关性。方法：选取在我科放疗的20岁到60岁的男性鼻咽癌患者。分别于放疗前,第1次放疗后,第5次放疗后,第10次放疗后,第15次放疗后,第20次放疗后,第25次放疗后,第30次放疗后,按照CTCAE(常用药物毒性标准V3.0)中干眼综合征的分级标准得出患者眼干的分级；同时通过泪液分泌实验,测出左右两侧泪腺分泌的功能值。并通过VARIAN系统得出其治疗方式,通过Eclipse计划系统得出泪腺体积,受照的相关剂量值。结果：总计34例病人共68眼,左右两侧泪腺体积都符合正态分布,左右两侧泪腺体积的差异没有统计学意义(p=0.815)；68眼泪腺的泪腺体积、受照平均剂量、最大剂量、最小剂量都符合正态分布。泪液的分泌量变化与治疗的次数无相关性。放疗结束后68眼中共有47眼出现I度眼干症状,占69.1%。,21眼未出现症状,占30.9%。8眼泪腺的放射性干眼症与泪腺体积的相关性没有统计学意义。放射性干眼症的出现与放疗的次数具有相关性,随着放疗次数增加,放射性干眼症几率也增大。放射性干眼症与患者的年龄具有相关性,不同年龄组与是否出现放射性干眼症有统计学差异。其中41-50岁组出现干眼症可能性最大(53.2%)；其次是31-40岁组(21.3%)；再次是20-30岁组(17.0%)；51-60岁组最少出现干眼症(8.5%)。68眼泪腺的放射性干眼症与受照平均剂量、最大剂量、最小剂量有相关性。68眼泪腺的放射性干眼症与照射方式具有相关性：出现放射性干眼症的几率：5野IMRT7野IMRT9野IMRT。68眼泪腺的放射性干眼症中,泪腺平均剂量、治疗方式、年龄是其危险因素。结论：放射性干眼症的出现与与泪腺体积无关,与放疗次数相关,放疗次数增加,出现放射性干眼症的几率增加。泪腺平均剂量、治疗方式、年龄是放射性干眼症的危险因素。
[Abstract]:Objective: to investigate the correlation between the incidence of radiation dry eye and the age, dose and treatment of nasopharyngeal carcinoma patients. Methods: male patients with nasopharyngeal carcinoma (NPC) aged 20 to 60 years were treated with radiotherapy in our department. After the first, the fifth, the tenth, the 15th, the 20th, the 25th, and the 30th, respectively, before and after the first, the fifth, the tenth, the fifteenth, the twentieth, the 25th, the 30th, the first, the fifth, the tenth, the 15th, the 20th, the 25th, the 30th, respectively. According to the classification standard of dry eye syndrome in CTCAE (common drug toxicity standard V3.0), the classification of dry eye syndrome was obtained, and the functional value of lacrimal gland secretion on right and left sides was measured by tear secretion experiment. The treatment method was obtained by VARIAN system and the relevant dose values of lacrimal gland volume and irradiation were obtained by Eclipse planning system. Results: there were 68 eyes in 34 patients. The volume of left and right lacrimal glands was in accordance with normal distribution. There was no significant difference in the volume of lacrimal glands between the left and right sides (p0. 815). The volume of lacrimal glands of the left and right sides of the patients was the average dose and the maximum dose. The minimum dose is in accordance with the normal distribution. There was no correlation between the amount of tear secretion and the times of treatment. There were 47 eyes with degree I dry eye symptoms in 68 eyes after radiotherapy, accounting for 69.1%. 21 eyes had no symptoms, and 30.9.8 eyes had no correlation between the volume of lacrimal gland and the radioactive xerophthalmia of tear gland. The occurrence of radiation dry eye is correlated with the times of radiotherapy, and the probability of radiation dry eye is increased with the increase of radiation frequency. There was a correlation between the age of the patients and the age of the patients, and there were statistical differences between the different age groups and the occurrence of radioactive dry eyes. Among them, 41-50 years old group had the highest risk of dry eye disease (53.2%), followed by 31-40 years old group (21.3%), 20 to 30 years old group (17.0%), 51-60 years old group had the least dry eye disease (8.5%) .68 average dose of radiation dry eye and irradiation, the maximum dose, The minimum dose of radioactive dry eye of tear gland is related to the way of irradiation: the probability of the occurrence of radiation dry eye is: 5 field IMRT7 field IMRT9 field IMRT.68 dry eye, the average dose of lacrimal gland, treatment method, Age is the risk factor. Conclusion: the occurrence of radioactive dry eye is not related to the volume of lacrimal gland but to the times of radiotherapy. The average dose of lacrimal gland, treatment, and age were risk factors for radiation dry eye disease.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R739.63;R777.34

【相似文献】