臨床中咽頭癌に対するIMRTによる粘膜炎とそれに伴った疼痛の検討

概要

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Radiation therapy in patients with head and neck cancers often triggers severe painful mucositis. Intensity Modulated Radiation Therapy (IMRT) allows higher radiation doses to be focused on regions within the tumor while minimizing the dose to surrounding normal critical structures. Recently IMRT has been used for the purpose of reduction of side effects. To better understand how IMRT is associated with fewer episodes of painful mucositis than conventional RT, we investigated examples of painful mucositis from 27 patients (IMRT group; 13 patients, conventional RT group; 14 patients) undergoing radiation therapy at 60-66 Gy for newly diagnosed mesopharyngeal cancer. We evaluated painful mucositis using numerical rating scale (NRS0-5) pain scores and Common Terminology Criteria for Adverse Events version 3.0 (CTCAE v3.0). We also investigated analgesic usage and the rate of receiving naso-gastric tube feeding. The area of mucositis was smaller and the pain course was milder in the IMRT group compared with the conventional RT group.