Functional changes of the gustatory organ caused by local radiation exposure during radiotherapy of the head-and-neck region
Functional changes of the gustatory organ caused by local radiation exposure during radiotherapy of the head-and-neck region
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DOI：
10.1007/s00066-008-1780-z
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发表时间：
2008-03-01
影响因子：
3.1
通讯作者：
Hildebrandt, Guido
中科院分区：
文献类型：
--
作者：
Kamprad, Friedrich;Ranft, Doerthe;Hildebrandt, Guido
目的：这项前瞻性研究的目的是探讨如何经常和在哪些剂量水平味觉障碍出现在放疗的舌头和在何种程度上永久味觉缺陷occupational.Patients和方法：该研究包括44例患者接受确定性放射治疗的恶性头颈部肿瘤。22例患者的舌后三分之二（第1组）和其他22例患者的整个舌（第2组）暴露于辐射。对照组包括30例接受确定性放射治疗的非小细胞肺癌患者（第3组）。使用基于CT的三维规划计算舌区的剂量分布。在照射前、照射中、照射后用味觉测量法测定味觉功能，并与口腔检查结果及患者对味觉功能的主观评价进行相关分析。对照组的味觉能力没有受到影响，而在局部照射组中，与口腔粘膜炎平行的患者在总剂量为20戈伊后味觉功能丧失，最大剂量为40 - 60戈伊。支持措施对急性不良反应影响不大。部分舌照射患者的味觉障碍在放疗后8周内消退，6个月后几乎完全消退。结论：全舌照射患者味觉障碍的严重程度和较长的恢复时间表明照射量的影响。因此，通过调强放疗减少高度暴露的舌体积为减少这种不良副作用提供了可能性。
Purpose: The aim of this prospective study was to investigate how often and at which dose Levels gustatory disturbances appear during radiotherapy of the tongue and to which extent permanent gustatory deficiencies occur.Patients and Methods: The study included 44 patients treated by definitive irradiation for malignant head-and-neck tumors. In 22 patients the posterior two thirds of the tongue (group 1), and in the other 22 patients the entire tongue (group 2) were exposed to radiation. The control group comprised 30 patients with non-small cell lung cancer receiving definitive radiation therapy (group 3). The dose distribution in the tongue area was calculated using CT-based three-dimensional planning. Before, during and after irradiation the gustatory function was determined by means of gustometry and correlated with the corresponding results of enoral inspection and the patients' subjective statements on gustatory function.Results: The gustatory ability of the control group was not affected, whereas patients in the Locally irradiated groups in parallel with enoral mucositis suffered from Loss of gustatory function after a total dose of 20 Gy with a maximum between 40 and 60 Gy. Supportive measures had Little influence on acute side effects. The gustatory disturbances regressed within 8 weeks after radiotherapy in patients with partial-tongue irradiation and almost completely after 6 months in patients with entire-tongue irradiation.Conclusion: The severity of gustatory disturbances and the longer recovery time in patients with entire-tongue irradiation suggest an influence of the volume exposed. Therefore, reduction of the highly exposed tongue volume by intensity-modulated radiotherapy opens up possibilities for a reduction of this undesirable side effect.