The Influence Of Radiochemotherapy To Parotid-gland Function In Nasopharyngeal Carcinoma Patients And The Intervention Effect Of Chinese Herbology

Objective: To investigate the influence of radiochemotherapy to parotid gland（PG） function in locally advanced nasopharyngeal carcinoma（NPC） patients（IIIA-IVa） and preliminary study the protective effect on PG of Chinese Traditional Medicine Gan Luyin.Methods: Enrolling 82 III-IVa NPC patients to receive chemoradiotherapy from June 2014 to August 2015 in oncology department of Affiliated Hospital of North Sichuan Medical College.20 NPC patients and 20 healthy people were checked SPECT radioactive dynamic imaging to compare based PG function;25 NPC patients accepted SPECT before and after induction chemotherapy to check influence of induction chemotherapy on PG function;46 N2-3 patients had completed induction chemotherapy were randomly divided into two groups, 26 cases in the test group, in which patients drank Gan Luyin since the beginning of concurrent radiochemotherapy（CCRT） to 3 months after that. Others in the control group only received CCRT. Patients in both groups were checked by SPECT before CCRT, when 15 fraction, at the end of CCRT, one and three months after radiotherapy. And the patients were evaluated the xerostomia degree at the above time as well as six month and one year after radiotherapy, and compared the efficacy. Delineating the GTV and PG before radiotherapy and during 15 fraction, 28 fraction of 82 patients to analysis the variety of both.Result: 1.NPC patients had no significant difference of PG UI with healthy people（P>0.05）, but the PG EI was lower（P<0.05）;2.No statistically significant comparison was seen between PG UI and EI of NPC patients before and after induction chemotherapy;3.Patients in test group shew no significant difference of xerostomia at 15 th fraction, at the end of CCRT, even one months and three months after radiotherapy with control group（P>0.05）,but showing lower xerostomia at six months and one year after radiotherapy（P<0.05）.4.The test group shew light damage of PG function than the control group at 15 th fraction（P <0.05）,but had no statistically significant at the end of CCRT and three months, six months after radiotherapy（P<0.05）.5 The volume of GTVnx and GTVnd decreased more significantly in the first 15 fractions than that between the 15 th and 25 th fraction（20.60±15.58% vs. 11.73±16.13% and 43.35±25.96% vs. 26.19±19.85%）,while the bilateral PGs had no significant difference（P>0.05）.Conclusion: 1.The secretion function of NPC patients is worse than health people. 2.Induction chemotherapy will not affect NPC patients’ PG function. 3. Gan Luyin has a protective effect on PG function in the first 15 fractions of radiotherapy, but not obvious in the late fractions. Besides, it can relieve xerostomia for the time three months after radiotherapy. 4.The volume of GTV decrease more significantly in the first 15 fractions than that between the 15 th and 25 th fraction, while that PG volume has no significant change is no significant difference in the two time periods. To protect the parotid gland function, it is better change the plan in the 15^th fraction.