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Evaluation of Xerostomia Following 3 Dimensional Conformal Radiotherapy for Nasopharyngeal Cancer Patients
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KMID : 0859320060240020081
Abstract
¸ñ Àû: 3Â÷¿ø ÀÔüÁ¶Çü ¹æ»ç¼±Ä¡·á¸¦ ½ÃÇà ¹ÞÀº ÄÚÀÎµÎ¾Ï È¯ÀÚ¿¡¼ ¼³¹®Á¶»ç¸¦ ÀÌ¿ëÇÏ¿© ±¸°°ÇÁ¶ÁõÀÇ ½Ã°£°æ°ú¿¡ µû¸¥ º¯È¾ç»óÀ» ºÐ¼®ÇÏ°íÀÚ ÇÏ¿´´Ù.
´ë»ó ¹× ¹æ¹ý: 2000³â 12¿ùºÎÅÍ 2005³â 8¿ù±îÁö ÄÚÀÎµÎ¾Ï È¯ÀÚ¿¡¼ 3Â÷¿ø ÀÔüÁ¶Çü ¹æ»ç¼±Ä¡·á¸¦ Àû¿ëÇÑ È¯ÀÚ 51¸íÀ» ¼³¹®Á¶»çÀÇ ´ë»óÀ¸·Î ÇÏ¿´´Ù. 3Â÷¿ø ÀÔüÁ¶Çü ¹æ»ç¼±Ä¡·á´Â 3ȸÀÇ ÄÄÇ»ÅÍ ´ÜÃþÃÔ¿µ(Computed tomography:CT)¸ðÀÇÄ¡·á¸¦ ÀÌ¿ëÇÑ 3´Ü°è Ä¡·á°èȹÀ» ½ÃÇàÇÏ´Â ¼øÂ÷Àû Á¶»ç¿µ¿ª Ãà¼Ò¹æ¹ýÀ» »ç¿ëÇÏ¿´°í, ÃÑ ¼±·® 72 Gy¸¦ ¸ñÇ¥·Î ÇÏ¿´´Ù. ±¸°°ÇÁ¶ÁõÀº ÀÏ»ó»ýÈ°¿¡¼ Áß¿äÇÑ 4°¡Áö Ç׸ñÀ¸·Î ±¸¼ºµÈ ¼³¹®Á¡¼ö(xerostomia questionnaire score: XQS)¸¦ ÃøÁ¤ÇÏ¿´À¸¸ç, ¹æ»ç¼±Ä¡·á ÈÄ °æ°ú½Ã°£, ¼ºº°, ³ªÀÌ, º´±â, Ç×¾ÏÄ¡·áÀÇ º´¿ëÀ¯¹«, ±×¸®°í ÀÌÇϼ±ÀÇ Æò±Õ ¹æ»ç¼±·® µî¿¡ µû¸£´Â Â÷À̸¦ ºÐ¼®ÇÏ¿´´Ù.
°á °ú: Ç×¾ÏÄ¡·á¸¦ º´¿ëÇÑ È¯ÀÚ°¡ 40¸í, ¹æ»ç¼±Ä¡·á ´Üµ¶È¯ÀÚ°¡ 11¸íÀ̾úÀ¸¸ç, ¹æ»ç¼±Ä¡·á ÈÄ ¼³¹®Á¶»ç±îÁö °æ°ú ½Ã°£Àº Áß¾Ó°ª 20 (1¡58)°³¿ùÀ̾ú´Ù. Àüü ȯÀÚ¿¡¼ XQS Á¡¼öÀÇ Æò±ÕÀº 8.4Á¡(ÃÖÇÏ 6Á¡, ÃÖ°í 14Á¡, Ç¥ÁØÆíÂ÷ 1.9) À̾ú´Ù. ¹æ»ç¼±Ä¡·á ÈÄ °æ°ú½Ã°£¿¡ µû¶ó XQS Á¡¼ö´Â Åë°èÀûÀ¸·Î À¯ÀÇÇÏ°Ô °¨¼ÒÇÏ´Â °æÇâÀ» º¸¿´´Ù(¥ö2=-0.484, p£¼ 0.05). ¼ºº°, ³ªÀÌ, º´±â¿¡ µû¶ó XQS Á¡¼öÀÇ Â÷ÀÌ´Â ¾ø¾ú°í, Ç×¾ÏÄ¡·á¸¦ º´¿ëÇÑ È¯ÀÚ¿¡¼ ¹æ»ç¼±Ä¡·á ´Üµ¶ ȯÀÚ¿Í ºñ±³ÇÏ¿© XQS Á¡¼ö°¡ À¯ÀÇÇÏ°Ô ³ô¾Ò´Ù(p=0.001). Àüü ÀÌÇϼ±ÀÇ Æò±Õ¼±·®Àº 35 Gy ¹Ì¸¸¿¡¼ 35 Gy À̻󺸴٠XQS Á¡¼ö°¡ Åë°èÀûÀ¸·Î À¯ÀÇÇÏ°Ô ³·¾Ò´Ù(p=0.05).
°á ·Ð: ÄÚÀÎµÎ¾Ï È¯ÀÚ¿¡¼ 3Â÷¿ø ÀÔüÁ¶Çü ¹æ»ç¼±Ä¡·á ÈÄ ÃøÁ¤ÇÑ XQS Á¡¼ö´Â ¹æ»ç¼±Ä¡·á ÈÄ ½Ã°£°æ°ú¿¡ µû¶ó °¨¼ÒÇÏ´Â ¾ç»óÀ» º¸¿´À¸¸ç, Ç×¾ÏÄ¡·á¸¦ º´¿ëÇÔÀ¸·Î½á ´õ ¾ÇȵǴ °æÇâÀÌ ÀÖ°í, ÀÌÇϼ±¿¡ Á¶»çµÇ´Â Æò±Õ¼±·®À» 35 Gy ¹Ì¸¸À¸·Î ÇÏ´Â °ÍÀÌ ±¸°°ÇÁ¶Áõ Áõ»ó¿ÏÈ¿¡ µµ¿òÀÌ µÉ ¼ö ÀÖ°Ú´Ù.
Purpose: This study is to evaluate the xerostomia following 3-dimensional conformal radiation therapy (3D CRT) in nasopharynx cancer patients using the xerostomia questionnaire score (XQS).
Materials and Methods: Questionnaire study was done on 51 patients with nasopharynx cancer who received 3D CRT from Dec. 2000 to Aug. 2005. 3D CRT technique is based on ¡°serial shrinking field¡± concept by 3 times of computed tomography (CT) simulation. Total target dose to the primary tumor was 72 Gy with 1.8 Gy daily fractions. Xerostomia was assessed with 4-questions XQS, and the associations between XQS and time elapsed after RT, age, sex, stage, concurrent chemotherapy, and parotid dose were analyzed.
Results: Concurrent chemotherapy was given to 40 patients and RT alone was given to 11 patients. The median time elapsed after 3D CRT was 20 (1¡58) months and the mean XQS of all 51 patients was 8.4¡¾1.9 (6¡14). XQS continuously and significantly decreased over time after 3D CRT (¥ö2=-0.484, p£¼0.05). There was no significant difference in XQS according to sex, age, and stag. However, XQS of concurrent chemotherapy patients was significantly higher than RT alone patients (p=0.001). XQS of patients receiving total mean parotid dose ¡Ã35 Gy was significantly higher than £¼35 Gy (p=0.05).
Conclusion: Decreasing tendency of XQS over time after 3D CRT was observed. Concurrent chemotherapy and total mean parotid dose ¡Ã35 Gy were suggested to adversely affect radiation-induced xerostomia.
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±¸°°ÇÁ¶Áõ;ÄÚÀεξÏ;3Â÷¿ø ÀÔüÁ¶Çü ¹æ»ç¼±Ä¡·á;Xerostomia;Nasopharynx cancer;3 dimensional conformal radiation therapy
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