| Objective:1.To investigate the effect of the Compound Sarcandra Glabra on radiation damage of parotid gland in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy.2.To verify the evaluation effect of dynamic salivary gland imaging on the degree of radiation parotid gland injury in patients with nasopharyngeal carcinoma.Materials and methods: 21 newly treated patients with nasopharyngeal carcinoma who received intensity-modulated radiotherapy and concurrent chemotherapy in The First Affiliated Hospital of Guangxi Medical University from June 2018 to January 2019 were collected and included as the treatment group.Patients in the treatment group were treated with Compound Sarcandra Glabraorally every day from 3 days before radiotherapy to the end of radiotherapy.The Maximum uptake rate(MAR)and maximal excretion rate(MSR)of the treatment group were determined through the 99mtco4-185 MBq salivary gland dynamic imaging method before radiotherapy,at the end of radiotherapy and 3 months after radiotherapy.At the same time,at the end of radiotherapy and 3 months after radiotherapy,the dry mouth rating was assessed.And then the MAR,MSR of and dry mouth rating of the treatment group before radiotherapy,at the end of radiotherapy and 3 months after radiotherapy wre compared.21 newly treated patients(not treated with Compound Sarcandra Glabraorally)with nasopharyngeal carcinoma who received intensity-modulated radiotherapy and concurrent chemotherapy in The First Affiliated Hospital of Guangxi Medical University from July 2016 to February 2017 were collected and included as the control group.The Maximum uptake rate(MAR)and maximal excretion rate(MSR)of the control group were determined through the 99mtco4-185 MBq salivary gland dynamic imaging method before radiotherapy and 3 months after radiotherapy.And the dry mouth rating was also assessed at the end of radiotherapy and 3 months after radiotherapy.The results of MAR and MSR of parotid gland before radiotherapy and 3 months after radiotherapy were compared between the treatment group and the control group,so were the dry mouth rating at the end of radiotherapy and three month after the radiotherapy between the treatment group and the control group.Results :(1)There was no grade 2 or above dry mouth in the treatment group and the control group at the end of radiotherapy and 3 months after radiotherapy.At the end of radiotherapy,the incidence of grade 1 dry mouth in the treatment group and the control group was 61.9%(13/21)and 28.6%(6/21),respectively.The incidence of grade 2 dry mouth was 38.1%(8/21)and 71.4%(15/21),respectively.3 month after radiotherapy,the incidence of grade 0 dry mouth of the treatment group and the control group was 14.3%(3/21)and 4.8%(1/21),respectively.The incidence of grade 1 dry mouth was 76.2%(16/21)and 57.1%(12/21),respectively.The incidence of grade 2 dry mouth was 9.5%(2/21)and 38.1%(8/21),respectively.At the end of radiotherapy,the difference of dry mouth rating between the treatment group and the control group was statistically significant(P=0.032).The difference in dry mouth rating between the two groups was also statistically significant 3 months after radiotherapy(P=0.018).The results of dry mouth rating at the end of radiotherapy and 3 months after radiotherapy were compared,and there were both significant differences in the treatment group and the control group(P values were 0.007 and 0.027,respectively).(2)Before,at the end of radiotherapy and 3 months after radiotherapy,The MAR of patients in the treatment group were 85.72±11.75%,81.52±14.88%and 72.53±15.13%,respectively.Before and at the end of the radiotherapy,the t value and P value were 1.675 and 0.101,respectively,and the difference of MAR in the treatment group was not statistically significant.At the end of radiotherapy and 3 months after radiotherapy,the t value was 2.526,P value was 0.016,and the difference of MAR in the treatment group was statistically significant.Before and 3 months after radiotherapy,the t value of MAR was 4.355,P value was less than 0.001,and the difference was statistically significant.(3)the MSR of parotid gland in the treatment group before radiotherapy,at the end of radiotherapy and 3 months after radiotherapy were 32.58±26.74%,2.24±16.86% and 8.25±13.62%,respectively.At the end of radiotherapy and 3 months after radiotherapy,the t value and P value of MSR was-2.178 and 0.035,respectively.The difference was statistically significant.The t value of parotid gland MSR before and 3 months after radiotherapy was 5.928,P value was less than 0.001,and the difference was statistically significant.(4)In the control group,MAR before and 3 months after radiotherapy were 82.01±21.73%and 57.94±29.93%,respectively.The t value was 4.580,P value was less than 0.001,and the difference was statistically significant.In the control group,the MSR of parotid gland before and 3 months after radiotherapy were 35.54±31.47%and 0.78±17.11%,respectively,and the t value was 7.062,P value was less than 0.001,and the difference was statistically significant.(5)Before radiotherapy,the t value of MAR and MSR of the parotid gland between the treatment group and the control group were 0.974 and-0.464,respectively,and the P values were 0.333 and 0.644,respectively.The differences were not statistically significant.At 3 months after radiotherapy,the t value of MAR and MSR of the parotid gland between the treatment group and the control group were 2.820 and 2.213,respectively,and the P values were 0.006 and 0.030,respectively,and the differences were statistically significant.Conclusion: This study suggests that Compound Sarcandra Glabra can effectively prevent and treat the radiation damage of the parotid gland in patients with nasopharyngeal carcinoma,so as to alleviate the degree of dry mouth in patients with nasopharyngeal carcinoma after radiotherapy and improve the quality of life of patients with nasopharyngeal carcinoma.In addition,salivary gland imaging has the advantages of noninvasive and convenient,and it is an effective method to objectively evaluate the radiation damage of parotid gland in nasopharyngeal carcinoma. |
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