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目的 :探讨预防、诊治放射治疗所致头颈部肿瘤患者的放射线损害。方法 :回顾分析头颈癌 2 5例放疗后发生并发症患者的临床资料。结果 :男 2 1例 ,女 4例 ,18～ 6 8岁 ,原发头颈肿瘤分别为 :鼻咽癌 2 1例 ,硬腭癌 1例 ,喉癌 1例 ,食道癌 1例 ,腮腺混合瘤 1例 ;放射线损害 30例次 :局部骨髓炎伴瘘管 5例次、神经损伤 2例次、上腔静脉综合征 1例次、鼻咽闭锁 1例次、腭瘘 2例次、颌面颈淋巴回流障碍 2例次、放疗诱发第二原发癌 9例次、局部溃疡大出血 4例次、颞颌关节强直 4例次。经保守治疗、手术及综合治疗 ,死亡 10例 ,其中 5例死于放疗所致的并发症 ,5例死于第二原发癌 ,生存期 3～ 4 3年 ,健在 15例 ,存活 7～ 37年。结论 :放疗对机体产生的各种损害多为不可逆 ,且随时间的推移逐渐累积和显现 ;严格掌握放疗指征 ,杜绝不必要的放疗 ;精确设计放射野和剂量 ,采用高能放射源及立体定向技术等能预防放射线损伤 ,综合治疗对放射线损伤有效
Objective: To explore the prevention of radiation damage in patients with head and neck cancers caused by radiation therapy. Methods: The clinical data of 25 patients with complications after radiotherapy were retrospectively analyzed. RESULTS: There were 21 males and 4 females, 18 to 68 years old. The primary tumors of the head and neck were: nasopharyngeal carcinoma (21 cases), hard palate cancer (1 case), laryngeal carcinoma (1 case), esophageal carcinoma (1 case), parotid gland mixed tumor (1). 30 cases of radiation damage: 5 cases of local osteomyelitis with fistula, 2 cases of nerve injury, 1 case of superior vena cava syndrome, 1 case of nasopharyngeal atresia, 2 cases of hemorrhoids, and 2 cases of maxillofacial lymphatic reflux There were 2 cases of disorder, 9 cases of second primary cancer induced by radiotherapy, 4 cases of partial ulcer bleeding, and 4 cases of temporomandibular joint stiffness. After conservative treatment, surgery, and comprehensive treatment, 10 patients died. Among them, 5 patients died of complications due to radiotherapy, 5 patients died of the second primary cancer, survival time was 3 to 43 years, 15 patients survived, and 7 survived. 37 years. Conclusion: All kinds of damages caused by radiotherapy on the body are irreversible, and they gradually accumulate and show up with time; strictly control the indications of radiotherapy and eliminate unnecessary radiotherapy; accurately design radiation fields and doses, use high-energy radioactive sources and stereotactic Technology can prevent radiation damage and comprehensive treatment is effective for radiation damage