■研究接受外束放射治疗(EBRT)的头颈部癌症(HNC)患者干眼症(DED)的发生率,为了找到肿瘤位置和DED总辐射剂量之间的相关性,并报告各种放射治疗(RT)对眼部和附件结构的急性毒性作用。
■一项前瞻性队列研究是在一个三级眼部护理中心,对2021年3月至2022年5月接受EBRT的90例HNC患者进行的。所有患者均接受了全面的临床病史和完整的眼科检查,包括眼表疾病指数(OSDI)问卷,视敏度,前段,角度和后段检查,干眼检查包括Schirmer测试,撕裂半月板高度,撕碎时间,角膜荧光素染色和分级,自动折射仪及其每次访问时的评分。患者在RT开始前进行评估,然后在1周进行评估,4周,RT后12周。记录所有患者的放射记录。使用百分比和MicrosoftExcel分析数据。
■在90名患者中,66名男性和24名女性(M:F比为2.75),中位年龄为52.5岁(范围24至80岁)。最常见的HNC是口腔和唇癌。大多数患者接受的总辐射剂量在46至55Gy之间。48例(53.3%)患者出现DED。DED的发生率随着总辐射剂量的增加而增加(r=0.987)。还发现DED与肿瘤位置相关(r=0.983)。
■DED的发生率与总辐射剂量和肿瘤位置呈正相关。
To study the incidence of dry eye disease (DED) in head and neck cancer (HNC) patients undergoing external beam radiotherapy (EBRT), to find a correlation between tumor location and total radiation dose with DED, and to report various radiotherapy (RT) induced acute toxic effects on ocular and adnexal structures.
A prospective cohort study was conducted at a tertiary eye-care center on 90 patients of HNC undergoing EBRT from March 2021 to May 2022. All underwent a thorough clinical history and complete ophthalmological examination including an ocular surface disease index (OSDI) questionnaire, visual acuity, anterior segment, angle and posterior segment examination, dry eye workup including the Schirmer test, tear meniscus height, tear break-up time, corneal fluorescein staining and grading, and meibography by auto-refractometer and its scoring at each visit. Patients were evaluated before the start of RT and then at 1 week, 4 weeks, and 12 weeks post-RT. Radiation records of all patients were noted. Data were analyzed using percentage and Microsoft Excel.
Of the 90 patients, 66 were male and 24 female (M: F ratio of 2.75) with a median age of 52.5 years (range 24 to 80 years). The most common HNC was the carcinoma oral cavity and lip. Most patients received a total radiation dose between 46 to 55 Gy. DED developed in 48 (53.3%) patients. The incidence of DED increased with the increase in total radiation dose (r = 0.987). DED was also found to be correlated with tumor location (r = 0.983).
The incidence of DED positively correlated with the total radiation dose and tumor location.