| Malignant tumor of nasopharyngeal carcinoma is common in China, onein head and neck malignant tumor incidence rates in the first place.Nasopharyngeal cancer radiation treatment instead of surgery in the treatmentof choice, first of all because of nasopharyngeal position to head the Central,peripheral parts of more subtle, adjacent to vital organs and tissue, cranialnerves, blood vessels, and so on. Surgical tumor resection of difficult, andextremely easy to damage surrounding tissue, increases the risk of surgery,surgery for nasopharyngeal carcinoma is poor; second rapid development of thedisease, in patients with nasopharyngeal carcinoma patients most of cervicallymph node metastasis has occurred, the transfer rates of up to60%-or to bothintracranial and cervical metastasis, also to the liver in the distance, bonemetastases. Nasopharyngeal carcinoma and pathological types mostly poorlydifferentiated Squamous Cell Carcinoma,95%. Earlier confirmed to be of only4%percent, patient is advanced. Radiation treatment is good again, the5-yearsurvival rate of up to49.5%.At present, the application of radiotherapy in nasopharyngeal carcinomapatients have achieved good effects, but due to the rapid growth ofnasopharyngeal carcinoma and high transfer rate characteristics, treatment ofthe disease has a high failure rate. Therefore, in order to further raise the levelof treatment of nasopharyngeal cancer, has been studying, including threedimensional Conformal radiotherapy (Three Dimensional Conformal,3DRT),intensity modulated radiation irradiation (Intensity Modulated RadiationTherapy, IMRT) and comprehensive treatment of some of the important tools,such as. Intensity modulated radiation therapy as a precise radiotherapy technique, is a recently developed new technologies, as intensity-modulatedradiation therapy technology matured, nasopharyngeal carcinoma tumor targetarea of the formation of a conformal dose distributions, and cuts down theamount of the surrounding normal tissues and organs has become possible.Studies have shown that IMRT on the premise of not reduce nasopharyngealtumor target dose, effectively protect normal tissue, thereby improving localtumor control rates and improving patients ’ quality of life, and has the potentialto be improving the survival rate.Integrated treatment is becoming a trend to the cancer therapy,radiotherapy and chemotherapy combined with an increasingly broadapplication in the same period. Chemotherapy and radiation therapy cancomplement, synergy, can control local radiotherapy, and chemotherapy cancontrol the body transfer, and chemotherapy drugs can increase the sensitivityof tumor cells to radiation therapy. Radiotherapy combined with thechemotherapy period will not affect the timing and process of radiation therapy,and most patients can withstand and complete the entire treatment process.Nasopharyngeal cancer in recent years widely used in clinical radiotherapy andchemotherapy, DDP alone (70~80mg/m2) programme of nasopharyngealcarcinoma treated by radiotherapy and chemotherapy in the same period. But inthe course of radiotherapy, radiation to kill tumors while inevitable damage tonormal tissues or organs, with the combination of radiotherapy andchemotherapy, its side effects of growing importance, affect the effect ofradiation therapy. Irradiation of nasopharyngeal carcinoma in radiotherapy areaincluding the nasopharynx and Oropharynx, oral, nasal, cervical lymph nodedraining and other anatomical parts. These parts once the mucous membraneexposure will cause acute radiation-induced mucosal reactions, most oftensuffer and are having the greatest effect on the patients oral and oropharyngealmucosa. Oral mucosa of patients with acute radiation-induced oral mucositis caused hemorrhage, Erosive and ulcerative, sore throat, difficulty inswallowing, eating difficulties and poor nutritional status, the impact of thetreatment compliance of patients with, causing great pain to the patient, caneven cause serious radioactive mucosa reaction interrupted the process oftreatment of individual patients. Tumor cells may occur in the treatment ofinterruption during acceleration and proliferation and thereby influence theeffects of cancer treatment. Domestic study of acute radiation-induced oralmucosa reaction caused by the majority of nursing staff on oral mucositis careexperience, factors and preventive measures of effect for oral mucositis alsothere is little correlation between research and reporting. Prediction of oralmucositis happen, is a prerequisite for prevention and treatment in a timelymanner. For some of the factors for early intervention, implementation of earlyintervention, can achieve the goal of prevention, so as to reduce the occurrenceof acute inflammation of the oral mucosa and effect of improving patients ’quality of life and cancer therapy.In the course of this study observed the treatment of nasopharyngealcarcinoma, different treatment of acute oral mucosa reaction caused by change,explore a simple conventional radiotherapy, pure intensity modulatedradiotherapy and conventional radiotherapy combined with synchronouschemotherapy and intensity modulated radiation therapy combined withchemotherapy on acute effects of oral mucosa reaction. On my86patients withuntreated nasopharyngeal carcinoma, randomly divided into4groups.Conventional radiotherapy, respectively group (RT), Conventional radiotherapycombined with synchronous chemotherapy group(RT+C), Intensity modulatedradiation therapy group(IMRT) And intensity-modulated radiotherapycombined with synchronous chemotherapy group(IMRT+C). Evaluation ofacute oral mucosa and RTOG/EORTC standards, record the extent of groupacute oral mucosa reaction, time of occurrence, and the Group of irradiation dose, compare the differences between the groups. Study finds groups of acuteoral mucositis in patients with100%, which3~4incidence levels,35%, and66.5%, respectively. Simple comparison of conventional radiotherapy andsingle set of intensity modulated radiation therapy no significant differences,conventional radiotherapy combined with synchronous chemotherapy groupand intensity-modulated radiotherapy combined with synchronouschemotherapy Group clearly higher than the purely conventional radiotherapyand intensity modulated radiation therapy groups and simple groups. Radiationtherapy did not reduce the incidence of acute oral mucosa reaction.Radiotherapy combined with synchronous chemotherapy will increase theincidence of severe oral mucositis. |
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