- 期刊
The Effects of Radiation Therapy on Salivary Function in Patients with Head and Neck Cancer
放射治療對於頭頸腫癌病人在唾液腺功能之影響
摘要
放射治療在頭頸腫癌的治療佔了一席很重要的地位，而唾液腺通常也正處於下射治療範圍內，因此常造成病人的吃乾、蛀牙，甚至因食慾不振而引起營養不足。所以研究放射治療對於唾液腺功能的影響也是重要的課題之一。 我們先把20位正常人當控制組，再把治療組分成鼻咽癌群(80人)及非鼻咽癌群(80人)，比較放射治療前後對於耳下腺及頜下腺功能的影響。使用之放射治療機為NEC LINAC 1004(4MV X-ray)，唾液腺造影儀為Toshiba GCA 90B/GMS -55C computerized Gamma camera, Radioisotope 為Tc-99mO4。造影每15秒一次，歷時30分共120 frams。而造影後15分鐘，給病人喝一些檸檬汁，以刺激唾液的分泌。 結果顯示唾液腺功能對於控制組及治療前的治療組，並無明顯差異；治療前的治療組，在性別及年齡方面亦無差異。鼻咽癌組在治療完成後3個月，其Maximal uptake rate有逐漸下降趨勢，而非鼻咽癌組則無顯著差異；其Excretion rate則兩群皆在治療後3~6個月間下降得最厲害，然後又慢慢上升。對於鼻咽碰癌病人而言，放射治療對於頜下腺的傷害比耳下腺較輕；而非鼻咽癌群則對頜下腺的傷害較大。
關鍵字
無資料並列摘要
Eighty nasopharynegeal carcinoma (NPC) patients and another eighty head and neck cancer (HNC, non-NPC) patients were enrolled as two experimental groups to study their salivary function by using Tc99m sialography. Twenty healthy subjects were also employed as a control group. The patients received an intravenous in jections of 4 mCi of 99mTc-pertechnetate (Tc-99mO4-). The data were collected at a rate of 1 frame per 15 seconds for the total time of 30 minutes, and the patients received stimulations for salivary secretion by ingesting 0.5cc of lemon juice 15 min after the start of data acquisition. The salivary function was measured on Pre-RT (radiation therapy), During-RT and Post-RT periods. The results shouwd no statistical significance for maximum uptake (%) and excretion rate (%) between Control and Pre-RT group on parotid or submandibular glands function. This was the same in the age groups (age below 40 and age above 40) and sex groups. The NPC group had a decreasing maximum uptake (%) 3 months after RT on both parotid glands and submanidubular glands, whereas the HNC group showed no obvious difference. The excretion rate (%) of both parotid and submandibular glands reached its lowest mark after 3-6 months in both the NPC and HNC groups and then started to recover progressively. For NPC patients, the raDiation damage to the parotid glands was greater than to the submandibular glands , whereas the effect was reversed on HNC patients. It is important that the radiation therapist should preserve salvary function whenever possible.