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目的探讨重组人白介素11(rhIL-11)联合传统含漱液在鼻咽癌放射性口腔黏膜炎防治中的应用效果。方法将2011年8月至2015年12月在广西医科大学第三附属医院肿瘤科确诊的150例鼻咽癌(中国2008分期Ⅲ~Ⅳa期)患者采用随机数表法分为观察组和对照组,每组75例。所有患者采用调强放疗联合奈达铂同步化疗。观察组应用rhIL-11与传统含漱液(碳酸氢钠、利多卡因、地塞米松混合液)交替含漱,对照组仅用传统含漱液单纯含漱,含漱从放疗开始至放疗结束。放疗过程中每天记录两组患者放射性口腔黏膜炎的分级。结果Ⅰ~Ⅳ级放射性口腔黏膜炎发生率观察组分别为6.8%、50.0%、37.8%、5.4%,对照组分别为1.4%、32.4%、54.9%、11.3%,观察组严重(Ⅲ、Ⅳ级)放射性口腔黏膜炎发生率明显低于对照组,差异均有统计学意义(P<0.05)。Ⅰ~Ⅳ级放射性口腔黏膜炎出现时间观察组分别在放疗(13.2±8.1)d、(22.2±7.1)d、(28.2±4.7)d、(34.6±2.1)d,对照组分别在放疗(10.2±8.3)d、(16.5±7.6)d、(20.9±4.3)d、(28.7±2.6)d,随着放疗时间延长,放射性口腔黏膜炎逐渐加重,观察组各级放射性口腔黏膜炎出现的时间均比对照组晚,差异均有统计学意义(P<0.05)。Ⅰ~Ⅳ级放射性口腔黏膜炎持续时间观察组分别为(23.2±8.3)d、(15.2±5.1)d、(10.7±4.8)d、(5.2±2.3)d,对照组分别为(18.2±8.6)d、(21.5±6.0)d、(15.9±6.3)d、(7.2±2.6)d,严重放射性口腔黏膜炎(Ⅲ、Ⅳ级)持续时间观察组均比对照组短,差异均有统计学意义(P<0.05)。结论 rhIL-11联合传统含漱液能明显降低鼻咽癌严重放射性口腔黏膜炎发生率,推迟放射性口腔黏膜炎的发生时间,缩短严重放射性口腔黏膜炎持续时间,在鼻咽癌放射性口腔黏膜炎防治中起到明显的作用。
Objective To investigate the effect of recombinant human interleukin-11 (rhIL-11) combined with traditional gargle in the prevention and treatment of radiation-induced oral mucositis in nasopharyngeal carcinoma. Methods A total of 150 cases of nasopharyngeal carcinoma (stage Ⅲ-Ⅳa in China 2008) diagnosed oncology in the Third Affiliated Hospital of Guangxi Medical University from August 2011 to December 2015 were randomly divided into observation group and control group , 75 cases in each group. All patients with intensity modulated radiotherapy combined with nedaplatin synchronous chemotherapy. In the observation group, rhIL-11 was alternately rinsed with traditional gargle (sodium bicarbonate, lidocaine and dexamethasone), while the control group was rinsed only with traditional gargle, rinsed from radiotherapy to the end of radiotherapy . Radioactive oral mucositis grading was recorded daily for both groups during radiotherapy. Results The incidences of Ⅰ ~ Ⅳ grade radiation-induced oral mucositis were 6.8%, 50.0%, 37.8% and 5.4% in the observation group and 1.4%, 32.4%, 54.9% and 11.3% in the control group respectively Grade) radioactive mucositis incidence was significantly lower than the control group, the difference was statistically significant (P <0.05). The incidence of grade Ⅰ ~ Ⅳ radiation oral mucositis in the observation group were respectively in the group of radiotherapy (10.2 ± 8.1) d, (22.2 ± 7.1) d, (28.2 ± 4.7) d and (34.6 ± 2.1) ± 8.3) d, (16.5 ± 7.6) d, (20.9 ± 4.3) d and (28.7 ± 2.6) d respectively. With the extension of radiotherapy time, radioactive mucositis increased gradually. Which were later than the control group, the differences were statistically significant (P <0.05). The duration of radioactive mucositis in grade Ⅰ ~ Ⅳ were (23.2 ± 8.3) d, (15.2 ± 5.1) d, (10.7 ± 4.8) days and (5.2 ± 2.3) days in control group and (18.2 ± 8.6) days in control group ), d (21.5 ± 6.0) d, (15.9 ± 6.3) d, (7.2 ± 2.6) d respectively. The duration of severe radiation-induced oral mucositis (Ⅲ, Ⅳ grade) in the observation group was shorter than that in the control group Significance (P <0.05). Conclusions rhIL-11 combined with traditional gargle can significantly reduce the incidence of severe radiation-induced oral mucositis in nasopharyngeal carcinoma, delay the onset of radiation-induced oral mucositis and shorten the duration of severe radiation-induced oral mucositis. In the play a significant role.