Clinical Historical Research On Controlling Oropharyngeal Radiation Damage Caused By Radiotherapy Of Nasopharyngeal Carcinoma With The Chinese Medicine Prescription Of Cleaning Away Heat And Toxic Material

BackgroundRadiation oropharyngeal mucosal injury is one of the radiotherapy comp lications of nasopharyngeal carcinoma, this disease can lead to dysphagia the patient can not tolerate radiation therapy, cause interruption of radiot herapy. Intergrative methods used in the treatment of radiation injury has an important advantage. The etiology and pathogenesis of oropharyngeal rad iation damage caused by radiotherapy of nasopharyngeal carcinoma is dominance of heat in the interior, qi and yin defciencying in Chinese medcine, so the treatment method is cleaning heat and detoxification, supplementing qi and nourishing yin.ObjectivesTo evaluate the efficiency of curing oropharyngeal mucositis caused by radiotherapy of nasopharyngeal carcinoma with the chinese medicine prescr iption of cleaning away heat and toxic material for guiding clinical treat ment, enhancing the clincinical efficacy.MethodsCollecting 64 patients with nasopharyngeal carcinoma who is in hospital in Guangdong Provincal Hospital of Traditional Chinese medicine or Guangzhou General Hospital of Guangzhou Military Region from January,2009 to March,2010. The patients is divided into Chinese medicine group and medicine group. All patients are cured by Varian 2300C linear accelerator. In the first group, the patients begin to take the prescription of cleaning away heat and detoxification:Sterculia scaphigera 15g, Oroxylum indicum Vent 15g, Radix Ophiopogonis 15g, Rhizoma imperatae 20g, twice a day, and gargle with normal saline 500ml+lidocaine 0.4ml+Vitamin B12 5mg,20ml twice a day at the same time afeter oropharyngeal radiation damage appears. In the second group, the patients began to gargle with normal saline 500ml+lidocaine 0.4ml+Vitamin B12 5mg,20ml twice a day. All patients were treated by Varian 2300C linear accelerator with supine position, thermoplastic mask fixed, signing after head and neck CT scanning, designing with radiotherapy planning system from Dutch company Nuclear Lin. The patients were cured with 6-MVX line with conventional fractionated irradiation,5 times/week,1.8～2. OGy/times, radiation dose 70～78Gy/35～39times/7～8 weeks.Prophylactic jugular irradiation 50Gy/25～28 times/5～5.5 weeks. Other radiation-sensitive cancer such as undifferentiated type of cancer, tumor regression after giving 40～50 Gy radation dose, the dose is decreased, maybe 66～70Gy.Result1 The time when oropharyngeal radiation damage caused by radiotherapy of nasopharyngeal carcinoma appeared is 19.1±1.7day after radiotherapyj in the first group, the other is 15.9±2.2 day, the two groups are statistically significant which is analysed by by independent-samples T test (P<0.05).2 The degree of oropharyngeal radiation damage caused by radiotherapy of nasopharyngeal carcinoma after 3 weeks and 7 weeks in the two groups are statistically significant which is analysed by by chi-square test.Conclusion1 The time when oropharyngeal radiation damage caused by radiotherapy of nasopharyngeal carcinoma appeared is delayed by taking the prescription of cleaning away heat and toxic material, is benefit to radiotherapy.2 The degree of oropharyngeal radiation damage caused by radiotherapyof nasopharyngeal carcinoma in the first group is better than the second one.