目的:患者有时会在放射治疗(RT)期间报告磷酸盐和幻影。然而,细节特征和相关因素还没有得到很好的理解。我们的前瞻性研究旨在调查幻影和磷的特征,为了确定影响发生的因素,RT期间此类感觉的强度和享乐(愉悦/不愉快)评级。
方法:我们共纳入106名患者(37名女性),在大脑区域接受RT的人,耳朵,鼻子,喉部(ENT),和身体的其他区域,持续时间为43±5天。在结构化医学访谈中收集病史和治疗参数。使用Sniffin棒气味鉴定试验在基线测量嗅觉功能。每周根据自我报告问卷记录Phantosmia和磷酸化。
结果:有37%的患者出现幻影,51%的人经历过磷烯,29%的人同时经历这两种感觉。膦通常被认为是一种耀眼的蓝色,白色和/或紫色光,幻影通常被认为是一种化学物质,金属或烧焦的气味。年龄较小(F=7.81,p<0.01),脑区辐射(χ2=14.05,p=0.02),没有味觉问题(χ2=10.28,p=0.01),和质子RT(χ2=10.57,p=0.01)与这些异常感觉有关。化学/粉尘暴露史预示着幻影的强度降低(B=-1.52,p=0.02)和不愉快程度降低(B=0.49,p=0.03)。相比之下,疾病(肿瘤)持续时间(B=0.11,p<0.01),食物过敏(B=2.77,p<0.01),癫痫(B=-1.50,p=0.02)影响磷强度。镇痛药的摄入预测了磷的更高的愉悦度(B=0.47,p<0.01)。
结论:在RT期间常见幻象和磷。治疗设置和个体唤醒水平影响发生,这种异常感觉的强度和快感。Phandosmias和phosphenes可能涉及更多的中枢神经而不是外周机制,它们可以通过激活不被认为是嗅觉或视觉网络一部分的区域来引发。
Patients sometimes report phosphene and phantosmia during radiation therapy (RT). However, the detail features and related factors are not well understood. Our prospective
study aimed to investigate the characteristics of phantosmias and phosphenes, to identify factors that influence the occurrence, intensity and hedonic (pleasantness/unpleasantness) ratings of such sensations during RT.
We included a total of 106 patients (37 women), who underwent RT in regions of the brain, ear, nose, throat (ENT), and other areas of the body for a duration of 43 ± 5 days. Medical history and treatment parameters were collected in a structured medical interview. Olfactory function was measured using the Sniffin\' Stick Odor Identification Test at baseline. Phantosmia and phosphene were recorded weekly based on a self-report questionnaire.
There were 37% of the patients experiencing phantosmias, 51% experiencing phosphenes, and 29% simultaneously experiencing both sensations. Phosphenes were typically perceived as a flashily blue, white and/or purple light, phantosmias were typically perceived as a chemical-like, metallic or burnt smell. Younger age (F = 7.81, p < 0.01), radiation in the brain region (χ2 = 14.05, p = 0.02), absence of taste problems (χ2 = 10.28, p = 0.01), and
proton RT (χ2 = 10.57, p = 0.01) were related to these abnormal sensations. History of chemical/dust exposure predicted lower intensity (B = -1.52, p = 0.02) and lower unpleasantness (B = 0.49, p = 0.03) of phantosmia. In contrast, disease (tumor) duration (B = 0.11, p < 0.01), food allergy (B = 2.77, p < 0.01), and epilepsy (B = -1.50, p = 0.02) influence phosphenes intensity. Analgesics intake predicted a higher pleasantness of the phosphenes (B = 0.47, p < 0.01).
Phantosmias and phosphenes are common during RT. The treatment settings and individual arousal level influence the occurrence, intensity and hedonic of such abnormal sensations. Phantosmias and phosphenes may involve more central neural than peripheral mechanism, and they could be elicited with activation of areas that are not regarded to be part of the olfactory or visual network.