【摘要】 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。更多还原

【Abstract】 Objective To study the role of recombinant human interleukin 11(rhIL-11) and traditional mouthwash in prevention and treatment of radiation-induced oral mucositis in patients with nasopharyngeal carcinoma(NPC).Methods One hundred and fifty patients with stage Ⅲ-Ⅳa NPC(Chinese 2008 Staging System) were randomly divided into study group(n=75) and control group(n=75) by random number table, who were diagnosed in the Department of Oncology of the Third Affiliated Hospital of Guangxi Medical University from August 2011 to December 2015. All patients received intensity-modulated radiotherapy and nedaplatinum chemotherapy. From the beginning to the end of radiotherapy, the study group applied rhIL-11 and traditional mouthwash(sodium bicarbonate, lidocaine and dexamethasone mixture) to gargle alternately, and the control group used traditional mouthwash only. The classification of radiation-induced oral mucositis in the process of radiotherapy was recorded every day. Results The incidence of stage Ⅰ-Ⅳ radiation-induced oral mucositis in the study group were 6.8%, 50.0%, 37.8%, 5.4%, respectively, which in the control group were 1.4%, 32.4%, 54.9%, 11.3% respectively. The incidence of serious radiation-induced oral mucositis(Ⅲ,Ⅳ) were significantly lower in the study group than the control group(P<0.05). In the study group, the time of stage Ⅰ-Ⅳ radiation-induced oral mucositis were in the radiation of(13.2±8.1) d,(22.2±7.1) d,(28.2±4.7) d,(34.6±2.1) d, which were in the radiation of(10.2±8.3) d,(16.5±7.6) d,(20.9±4.3) d,(28.7±2.6) d in the control group. As the radiotherapy time extended, radiation-induced oral mucositis aggravated gradually, and the time of all stages of radiation-induced oral mucositis in study group was significantly later than that in control group(P<0.05). In the study group, the duration of stage Ⅰ-Ⅳ radiation-induced oral mucositis were(23.2±8.3) d,(15.2±5.1) d,(10.7±4.8) d,(5.2±2.3) d, which in the control group were(18.2±8.6) d,(21.5±6.0) d,(15.9±6.3) d,(7.2±2.6) d. The duration of serious oral mucositis(Ⅲ, Ⅳ) in the study group were significantly shorter than that in the control group(P<0.05). Conclusion rhI L-11 combined with traditional mouthwash could significantly reduce the incidence of serious radiation-induced oral mucositis in patients with NPC, delay the occurrence of radiation-induced oral mucositis, and shorten the duration of severe radiation-induced oral mucositis, which plays a significant role in prevention and treatment of radiation-induced oral mucositis in patients with NPC.更多还原