冷冻治疗与标准口腔护理预防头颈部肿瘤患者同步放化疗口腔黏膜炎的疗效比较

Mohammad Saiful Islam Pathan, M. Khan, T. Sultana, Mohammad Ashraf-Us-Zaman Mahmud, Dipok Saha, Atm Shazzaeatur Rahaman, Md Rakibul Islam Masud, Mohammad Arifur Rahman, Mohammed Shorfuddin Patowary, Altaf Hossain, Sarker Md Tanvir, Suman Paul, Mukti Rani Datta, Nahid Naznin Rinky
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引用次数: 0

摘要

2020年11月至2021年10月,在孟加拉国达卡国家癌症研究所和医院(NICRH)放射肿瘤科进行了一项准实验研究,以确定冷冻治疗与标准口腔护理相比,在接受CCRT期间预防头颈癌患者口腔黏膜炎的疗效。采用目的抽样技术,按照纳入和排除标准,共纳入100例患者(每组50例)。A组和B组的所有患者共接受66次格雷治疗,分为每天33次、每天1次、每周5次和注射。放疗第1天前2/3小时静脉滴注顺铂40mg/m²,之后每周滴注。A组接受冷冻治疗,B组接受标准口腔护理。干预从CCRT第1天开始至CCRT结束。采用WHO口腔黏膜炎分级和视觉模拟评分法(VAS)评价治疗效果。所有的信息都记录在一份预先测试的半结构化问卷中。共纳入100例患者(每组50例)。A组和B组患者的平均年龄分别为55.28±7.82和55.92±8.33。两臂男女比例为6.14:1。其他人口统计学特征、基线特征在两组间均无统计学意义(P>0.05)。B组第5周和A组第6周分别出现3级黏膜炎。CCRT期间第5周至治疗结束后4周-3级黏膜炎发生率分别为6%比0%、14%比6%、22%比10%、14%比6%、8%比2%,B组和A组差异有统计学意义(p < 0.05)。然而,在CCRT第3周至完成后4周,差异有统计学意义(P<0.05)。CCRT期间的冷冻治疗可能比维持标准的口腔护理更有利于预防口腔黏膜炎和疼痛。中华医学杂志2023年1月12期第12期[01:03 . 11
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of Cryotherapy in Comparison to Standard Oral Care to Prevent Oral Mucositis during Concurrent Chemoradiotherapy in Head and Neck Cancer Patients
A quasi-experimental study was conducted at Radiation Oncology Department of National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh, between November 2020 and October 2021, to determine the efficacy of cryotherapy in comparison to standard oral care to prevent oral mucositis in head and neck cancer patients during receiving CCRT. A total 100 Patients (50 patients in each arm) were included in this study according to inclusion and exclusion criteria by purposive sampling technique. All patients in Arm A and Arm B received total 66 Gray in 33 daily fractions, 1 fraction per day, 5 fractions per week and inj. Cisplatin 40mg/m² was given intravenously 2/3 hours before radiotherapy on 1st day and then weekly. Arm A received cryotherapy and Arm B received standard oral care. Intervention started from the 1st day of CCRT up to the end of CCRT. WHO oral mucositis grading and visual analogue scale (VAS) were employed to determine the effects. All the information was recorded in a pre-tested semi-structured questionnaire. Total 100 patients (50 patients in each arm) were enrolled. Mean age of the patients of Arm A and Arm B was 55.28±7.82 and 55.92±8.33 respectively. Male and female ratio was 6.14:1 in two Arms. Other demographic profile, baseline characteristics were statistically not significant in both arms (P>0.05). The grade-3 mucositis appeared after 5th week in Arm B and after 6th week in Arm A. The incidence of grade- 3 mucositis after 5th week during CCRT to 4 weeks after completion of therapy was 6% vs 0%, 14% vs 6%, 22% vs 10%, 14% vs 6%, 8% vs 2%, respectively for arm B and Arm A (P<0.05). Total number of patients suffering from grade 3 mucositis was 6 (12%) and 12 (24%) for Arm A and Arm B respectively (p value was <0.05). The mean duration of grade-3 or more mucositis between Arm A and Arm B was 2.04±1.78 and 10±1.72 days respectively (P<0.05). The difference of median pain intensity between two arms was not statistically significant for 1st and 2nd week (P>0.05). However, it was significant after 3rd week during CCRT to 4 weeks after completion of CCRT (P<0.05). Cryotherapy during CCRT may be beneficial to prevent oral mucositis and pain than maintaining standard oral care. CBMJ 2023 January: vol. 12 no. 01 P: 03-11
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