- 期刊
鼻咽癌再放射治療後的前庭器官疾患
Vestibular Apparatus Disorders in Patients with Nasopharyngeal Carcinoma Following Reirradiation
摘要
目的：研究鼻咽癌再放射治療對前庭器官之影響，並探討相關致病因子。病人與方法：收集10年來於本院追蹤之52名曾接受再放射治療病人做回顧研究，其中9名病患被診斷有前庭系統疾患。診斷方法包括詳細病史詢問與理學檢查、聽力及平衡功能檢查，而後者則包含illegible E-test、refixation saccade、兩側溫差測驗、眼振電圖及旋轉椅檢查。結果：9名病人中，7名病人診斷有兩側前庭功能喪失，1 名為左側前庭神經炎，1名為良性陣發性姿勢眩暈。7名兩側前庭功能喪失病人皆有兩側中耳炎之病史及中重度聽障，而illegible E-test vv refixation saccade test、兩側溫差測驗、眼振電圖及旋轉椅檢查除病人無法測試外，皆可做為診斷參考。9名放射治療劑量皆超過12,000cGy。結論：鼻咽癌再放射治療後前庭器官疾患以兩側前庭功能喪失最常見，因而已接受高劑量輻射。本研究顯示若合併有嚴重聽力喪失及中耳炎者則較易發生此疾。
並列摘要
Objective: We studied the effect of reirradiation to the vestibular apparatus in patients with nasopharyngeal carcinoma (NPC). Patients and Methods: A total of 52 reirradiated NPC patients underwent regular follow-up at Tzu Chi Hospital. Nine were diagnosed with vestibular apparatus disorders, based on detailed histories and balance function tests which included an illegible E-test, and refixation saccade test as well as bithermal air caloric and rotary chair tests. The clinical characteristics were analyzed. Results: Of 9 patients with vestibular apparatus disorders, seven had bilateral loss of vestibular function, one had vestibular neuronitis and one had benign paroxysmal positional vertigo. The 7 patients with bilateral loss of vestibular function had bilateral otitis media and moderate to profound bilateral haring loss. Illegible E-test, refixation saccade test, electronystagmography, bithermal air caloric test and rotary chair test are useful tools for diagnosis. All 9 patients receied total radiation dosages over 12,000 cGy. Conclusions: Bilateral loss of vestibular function is the most common vestibular apparatus disorder in patients with nasopharyngeal carcinoma following reirradiation. Severe hearing loss and otitis media after high dosage radiation may predispose a patient to this disorder.
延伸閱讀
- Lee, C. C., Juan, C. J., Liu, Y. J., Chen, C. Y., Jen, Y. M., Lin, Y. S., Lo, C. P., Peng, Y. J., Huang, G. S., Chu, C. H., & Wen, H. (2006). 鼻咽癌放射線治療後併發上頜竇之惡性纖維組織細胞瘤：早期磁振造影影像特徵. 中華放射線醫學雜誌, 31(5), 237-241. https://www.airitilibrary.com/Article/Detail?DocID=10188940-200610-31-5-237-241-a
- Chung, C. H., Yeh, C. Y., & Lai, Y. L. (1994). 鼻腔癌放射線治療結果. 中華放射線醫學雜誌, 19(2), 131-136. https://www.airitilibrary.com/Article/Detail?DocID=10188940-199406-19-2-131-136-a
- 白冰清、曾雁明、劉千如、李石增、湯國政（1997）。放射手術與多照野放射治療早期復發性鼻咽癌之臨床病例報告。放射治療與腫瘤學，4(1)，65-69。https://doi.org/10.6316/TRO/199704(1)65
- 陳培榕、徐莉萍、劉正瑩（2001）。Loss of Bilateral Vestibular Function Following Radio-Therapy in Patients with Nasopharyngeal Carcinoma。中華民國耳鼻喉科醫學雜誌，36(2)，79-83。https://doi.org/10.6286/2001.36.2.79
- Chang, Y. K., Hwang, J. M., Chang, C. S., & Wu, S. (2010). Preliminary Results of Intensity-Modulated Radiotherapy in the Treatment of Nasopharyngeal Carcinoma. 放射治療與腫瘤學, 17(2), 101-112. https://doi.org/10.6316/TRO/201017(2)101