頭頸癌患者放射線治療對產生口乾分析

放射線治療是用來治療頭頸部癌症患者的方法之一。在使用放射線療法治療頭頸部癌症之後，病人會同時會伴隨著破壞製造唾液腺體之狀況, 並引發口水分泌功能下降, 導致口乾、吞嚥、發聲之困難, 甚至引起患者睡眠障礙。本實驗研究之目主要是在探討為如何改善在接受放射線治療與操作之後，可以減輕口乾的現象。在口乾的測量部分分別採用醫生評估之口乾程度量表以及病人自填口乾問卷之分數, 資料來源為國內長庚醫院放射腫瘤科使用放射線治療之頭頸部癌症患者67 人之資料, 針對每位患者分別在放射線治療後六個月、一年及兩年進行紀錄。並利用縱向模式與邏輯斯迴歸模式來加以探討放射線治療劑量對於口乾症之因果關係。研究結果得知，影響口乾症的主因素如下所示: 1.左右兩邊的耳下腺體的平均劑量 2.左右兩邊頷下腺體平均劑量 3.全頷下腺體平均劑量與時間建議減少耳下腺體的平均劑量或降低V15、V30與V45在耳下腺體的劑量或提高頷下腺體的平均劑量, 這些因素將可協助醫療人員進一步預測患者口乾問題, 並有效減少口乾症的發生。

關鍵字

放射線；頭頸癌；口乾症；耳下腺；頷下腺；縱向模型；邏輯斯迴歸

並列摘要

Radiotherapy(RT) is one kind of therapies for Head and Neck Cancer patients. Salivary glands had been destroyed of Head and Neck Cancer patients and lead to many syndromes (include dysphasia, xerostomia and Dysphagia dysarthria ) even cause sleep disorders after radiotherapy. In our research, we focus on how to improve dysphasia after radiotherapy. To estimate scales of measure in xerostomia, we collect data from questionnaire filled by patients and clinical assessment by physicians. Our data were source of Department of Radiation Oncology, Chang Gung Memorial Hospital. This department offers 67 head and neck cancer patients has accepted radiotherapy and then to record at three different point in time: six month、one year and two year after radiotherapy for each patient. We use longitudinal and logistic regression model to explore the relationship between radiotherapy dose and xerostomia. The result shown that the main factors affecting xerostomia as follows: 1. The average dose in left and right parotid gland 2. The average dose in left and right submandibular gland 3. The average dose and time in submandibular gland We suggest that decrease the mean radiotherapy dose or V15、V30 and V45 in parotid gland or increase the mean radiotherapy dose in submandibular gland. These factors can help health care to predict the xerostomia before the patients use radiotherapy and then improve reduce the incidence of xerostomia.

並列關鍵字

Radiotherapy(RT) ； Head and Neck Cancer ； Parotid gland ； Submandibular gland ； Xerostomia ； Longitudinal models ； Logistic regression model ； Salivary glands

參考文獻

[1] 財團法人台灣癌症基金會http://www.canceraway.org.tw

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頭頸癌患者放射線治療對產生口乾分析

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