山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (6): 14-17.doi: 10.6040/j.issn.1673-3770.0.2016.105

• 论著 • 上一篇    下一篇

鼻咽癌调强放疗后前庭功能损伤的机制研究

刘叶1,孙殿水1,殷进军2,夏明3,徐英1,孙建华1   

  1. 1. 山东大学第二医院肿瘤防治中心, 山东 济南 250033;
    2. 威海市立医院放疗科, 山东 威海 264200;
    3. 山东大学第二医院耳鼻咽喉头颈外科, 山东 济南 250033
  • 收稿日期:2016-03-13 出版日期:2016-12-16 发布日期:2016-12-16
  • 通讯作者: 孙殿水. E-mail:sundianshui@163.com E-mail:guohaitao2005@163.co
  • 作者简介:刘叶. E-mail: guohaitao2005@163.co

Vestibular function damage mechanisms in nasopharyngeal carcinoma patients after intensity-modulated radiotherapy.

LIU Ye1, SUN Dianshui1, YIN Jinjun2, XIA Ming3, XU Ying1, SUN Jianhua1   

  1. 1. Cancer Center, the Second Hospital of Shandong University, Jinan 250033, Shandong, China;2. Cancer Center, Weihai Municipal Hospital, Weihai 264200, Shandong, China;3. Department of Otorhinolaryngology &Head and Neck Surgery, the Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Received:2016-03-13 Online:2016-12-16 Published:2016-12-16

摘要: 目的 探讨鼻咽癌调强放疗后前庭功能损伤的可能机制。 方法 分析内耳放疗受量和中耳炎与前庭功能损伤的相关性,用ELISA检测患者放疗前后血清IL-6和IL-17水平的变化。 结果 有38例符合研究标准的患者,内耳的放疗受量与前庭功能损伤明显相关(P<0.05),中耳炎与前庭功能损伤无明显相关性(P>0.05),放疗后血清IL-6和IL-17水平明显升高(P<0.05),并与前庭功能损伤明显相关(P<0.05)结论 鼻咽癌调强放疗后前庭放疗受量和前庭炎症反应与前庭功能损伤有关,而中耳炎未见对前庭功能损伤有影响。

关键词: 鼻咽肿瘤, 调强放疗, 炎症细胞因子, 前庭功能损伤

Abstract: Objective To explore potential mechanisms of vestibular function damage in nasopharyngeal carcinoma(NPC)patients after intensity-modulated radiotherapy(IMRT). Methods Patients who received radical IMRT for their NPC were recruited. The serum levels of IL-6 and IL-17 were detected with ELISA method. Vestibular evoked myogenic potential(VEMP)tests were used to evaluate vestibular function and correlation analyses were used to analyze the potential mechanisms of vestibular function damage. Results Thirty-eight patients were included. The mean and maximum radiation doses to the inner ears were both significantly associated with abnormal ocular VEMP(oVEMP)and cervical VEMP(cVEMP)(P<0.05, all), but the correlations were all mild. There were no significant correlations between otitis media(OM)and abnormal oVEMP and cVEMP(P>0.05). The serum levels of IL-6 and IL-17 in NPC patients both increased and were significantly associated with abnormal oVEMP and cVEMP after irradiation(P<0.05, all). Conclusion The radiation doses to the inner ears were associated with the incidence of vestibular function damage, but the correlations were mild. OM had no relations with the incidence of vestibular function damage in present study. The inflammatory responses and possible resolution obstacles of inflammation participated in persistent vestibular function damage after irradiation.

Key words: Nasopharyngeal carcinoma, Vestibular function damage, Inflammatory cytokines, Intensity-modulated radiotherapy

中图分类号: 

  • R739.2
[1] Low W K, Toh S T, Wee J, et al. Sensorineural hearing loss after radiotherapy and chemoradiotherapy: a single, blinded, randomized study[J]. J Clin Oncol, 2006, 24(12):1904-1909.
[2] 徐英,孙殿水,姜玉华,等.鼻咽癌调强放疗后前庭功能障碍发生情况观察[J].山东医药,2016,56(6):78-79.
[3] Chi F H, Young Y H. Inner ear deficits in irradiated nasopharyngeal carcinoma survivors[J]. Laryngoscope, 2015, 125(11):2565-2571.
[4] Gibb A G, Loh K S. The role of radiation in delayed hearing loss in nasopharyngeal carcinoma[J]. J Laryngol Otol, 2000, 114(2):139-144.
[5] Tseng C C, Wang S J, Young Y H. Comparison of bone-conducted vibration for eliciting ocular vestibular-evoked myogenic potentials: forehead versus mastoid tapping[J]. Otolaryngol Head Neck Surg, 2012, 146(2): 289-294.
[6] Tseng C C, Wang S J, Young Y H. Comparison of head elevation versus rotation methods for eliciting cervical vestibular evoked myogenic potentials via bone-conducted vibration[J]. Int J Audiol, 2013, 52(3):200-206.
[7] Hsin C H, Chen T H, Young Y H, et al. Comparison of otologic complications between intensity-modulated and two-dimensional radiotherapies in nasopharyngeal carcinoma patients[J]. Otolaryngol Head Neck Surg, 2010, 143(5):662-668.
[8] Young Y H, Lin K L, Ko J Y. Otitis media with effusion in patients with nasopharyngeal carcinoma, post-irradiation[J]. Arch Otolaryngol Head Neck Surg,1995,212(7):765-768.
[9] 殷蔚伯,余子豪,徐国镇,等. 肿瘤放射治疗学[M]. 4版. 北京:中国协和医科大学出版社,2008: 248.
[10] Shabgah A G, Fattahi E, Shahneh F Z. Interleukin-17 in human inflammatory diseases[J]. Postepy Dermatol Alergol, 2014, 31(4):256-261.
[11] Singh R P, Hasan S, Sharma S, et al. Th17 cells in inflammation and autoimmunity[J]. Autoimmun Rev, 2014, 13(12):1174-1181.
[1] 杜志宏. 电子鼻咽镜下口鼻联合径路在鼻咽部活检中的应用[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 117-118.
[2] 周荧,徐亚如,黄骁辰,陈渊,章明炯,张大为,唐奇,朱进,陈仁杰. 靶向c-Met嵌合抗原受体T细胞的制备及其对鼻咽癌细胞作用的研究[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 49-54.
[3] 唐隽, 施思斯, 于青青, 萧建新, 张超. 鼻咽癌放疗后继发慢性鼻窦炎的临床特征[J]. 山东大学耳鼻喉眼学报, 2015, 29(2): 52-54.
[4] 石大志1, 李建明2,罗志强1,罗琴1,敬前程1. 妊娠期鼻咽恶性肿瘤临床分析[J]. 山东大学耳鼻喉眼学报, 2014, 28(3): 28-30.
[5] 张小鹏1,边枫2,王丽新2. 环氧合酶-2及表皮生长因子受体在鼻咽癌中的表达及相关性[J]. 山东大学耳鼻喉眼学报, 2014, 28(3): 23-27.
[6] 杜晓东,宋红毛,马美,徐桂容,舒畅,程冯. 双管置入治疗鼻咽癌放疗后分泌性中耳炎[J]. 山东大学耳鼻喉眼学报, 2011, 25(4): 36-.
[7] 包伟晶,林昶,李志春. 光催化纳米TiO2治疗鼻咽癌基础研究[J]. 山东大学耳鼻喉眼学报, 2011, 25(2): 68-.
[8] 刘蓉蓉,姬长友,陈继川. 重组人p53腺病毒注射液(今又生)联合放疗治疗复发性鼻咽癌疗效观察[J]. 山东大学耳鼻喉眼学报, 2010, 24(5): 13-16.
[9] 朱国臣,张永胜,郑晓彬,肖大江. 乙酰肝素酶、nm23-H1在鼻咽癌中的表达以及与侵袭转移的关系[J]. 山东大学耳鼻喉眼学报, 2010, 24(4): 30-33.
[10] 陈洽鑫 综述 张志钢 郑亿庆 审校. 放射性分泌性中耳炎[J]. 山东大学耳鼻喉眼学报, 2009, 23(4): 35-37.
[11] 李军政,江东新,陈伟南,焦文成,高翔,黄佩仪,梁悦浓,陈文弦. 鼻内镜下咽鼓管置管治疗鼻咽癌放疗后分泌性中耳炎[J]. 山东大学耳鼻喉眼学报, 2009, 23(3): 15-16.
[12] 李海英,刘韶平,刘芳
. 鼻咽癌放疗后颈部残余淋巴结超声检查
与病理活检的对照
[J]. 山东大学耳鼻喉眼学报, 2009, 23(2): 12-14 .
[13] 吉文婷综述, 殷善开, 陈斌审校
. 鼻咽癌放疗后耳鼻咽喉科常见并发症的诊疗原则[J]. 山东大学耳鼻喉眼学报, 2009, 23(1): 36-39 .
[14] 雷迅1 ,刘强和1 ,孔中雨1 ,向秋2 ,耿宛平1 ,黄辉3 ,董译元1 ,刘芳贤1
. EGCG对鼻咽癌细胞株裸鼠移植瘤的放疗增敏作用以及对Survivin表达的影响[J]. 山东大学耳鼻喉眼学报, 2009, 23(1): 6-9 .
[15] 程金妹,谢振宇,林 勤,张鹏飞,林 英,易自翔,田为中 . 抑癌基因PTEN在鼻咽癌中的表达及突变[J]. 山东大学耳鼻喉眼学报, 2008, 22(5): 405-407 .
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!