放射治疗和头癌中的嗅觉功能:非随机临床试验
Geng-He Chang1, Yao-Te Tsai1, Meng-Hung Lin2
1Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan, Republic of China.
JAMA network open
|February 3, 2026
概括
头癌 (HNC) 的放射治疗 (RT) 可以导致嗅觉功能障碍. 嗅觉区域的22 Gy剂量是关键值,更高的剂量增加了长期嗅觉障碍的风险.
科学领域:
- 在瘤学瘤学.
- 辐射疗法 辐射疗法
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 头癌 (HNC) 患者在放射治疗 (RT) 后经常经历嗅觉功能障碍.
- 有限的前性数据存在于嗅觉功能障碍,特别是强度调制RT (IMRT).
研究的目的:
- 在接受IMRT的HNC患者中评估RT与嗅觉功能之间的关联.
- 在治疗后的时间内跟踪嗅觉功能的变化.
主要方法:
- 一项非随机临床试验包括63名接受IMRT治疗的HNC患者.
- 嗅觉功能使用台湾嗅觉识别测试在RT之前,期间和在RT后12个月内进行评估.
- 鼻腔内镜排除了混的鼻子状况.
主要成果:
- 在辐射剂量和嗅觉功能障碍之间发现了中度的正相关性.
- 嗅觉区域辐射剂量超过22 Gy被确定为嗅觉功能障碍的独立风险因素 (OR,20.65).
- 在一些患者中观察到持续的嗅觉功能障碍,在RT后长达1年.
结论:
- 在HNC患者中,RT显示了与嗅觉功能障碍的剂量依赖关系.
- 22 Gy作为评估嗅觉障碍的临界值剂量.
- 优化RT规划以减少嗅觉区域的辐射剂量可能会减轻长期的嗅觉功能障碍.
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