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目的:评价颌下腺移位术预防鼻咽癌放疗后口干燥症的安全性。方法:选择符合入选标准的鼻咽癌患者70例,分为试验组36例和对照组34例。试验组放疗前将颌下腺移位至颏下区,术后接受常规放疗,放疗时颏下区设置挡块。对照组直接行常规放疗。比较试验组和对照组的口干程度、5年颈淋巴结复发率及5年生存率。结果:放疗后60个月,对照组中度至重度口干燥症的发生率高于试验组(78.6%vs12.9%),差异有统计学意义,P=0.000。试验组和对照组颈部淋巴结复发率分别为11.1%(4/36)和11.8%(4/34),两者之间差异无统计学意义,P=0.93。复发部位均在Ⅱ区。5年生存率试验组为86.1%(31/36),对照组82.4%(28/34),两者之间差异无统计学意义,P=0.67。结论:颌下腺移位术可预防鼻咽癌放疗后口干燥症,改善鼻咽癌患者放疗后的生存质量。颌下腺移位术预防鼻咽癌放疗后口干燥症不影响鼻咽癌远期疗效且安全可行。
OBJECTIVE: To evaluate the safety of submandibular gland shunting in preventing xerostomia after radiotherapy of nasopharyngeal carcinoma. Methods: Seventy patients with nasopharyngeal carcinoma who met the inclusion criteria were divided into experimental group (36 cases) and control group (34 cases). In the experimental group, the submandibular glands were transplanted to the submental area before radiotherapy, and received routine radiotherapy after surgery. The block was set in the submental area during radiotherapy. The control group received routine radiotherapy. The degree of dry mouth, 5-year cervical lymph node recurrence rate and 5-year survival rate were compared between the experimental group and the control group. Results: At 60 months after radiotherapy, the incidence of moderate to severe xerostomia in the control group was significantly higher than that in the experimental group (78.6% vs 12.9%), with a significant difference (P = 0.000). The recurrence rates of cervical lymph nodes in experimental group and control group were 11.1% (4/36) and 11.8% (4/34) respectively, with no significant difference between the two groups (P = 0.93). Recurrent sites are in Ⅱ area. The 5-year survival rate was 86.1% (31/36) in the trial group and 82.4% (28/34) in the control group, with no significant difference between the two groups (P = 0.67). Conclusion: Submandibular gland transposition can prevent xerophthalmia after radiotherapy of nasopharyngeal carcinoma and improve the quality of life of patients with nasopharyngeal carcinoma after radiotherapy. Submandibular gland transposition to prevent nasopharyngeal carcinoma after radiotherapy xerostomia does not affect the long-term efficacy of nasopharyngeal carcinoma and safe and feasible.