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目的:探讨鼻咽癌(NPC)放射治疗眼部并发症。方法:对 213 例 NPC 初程放疗患者进行跟踪观察。放疗前、放疗中及放疗后作视功能(包括远视力、裂隙灯活体显微镜、眼底、自动电脑视野及视诱发电位)检查和角膜荧光素染色。结果:发生角膜损伤 19 例,占 8.9 %(19/213)。I～Ⅱ期6 例,Ⅲ期 8 例,Ⅳ期 5 例。全部发病患者均无角膜刺激症状,放疗后 10mo 内,角膜病变消退,但知觉仍较对侧眼明显减退;20mo 后尚未恢复正常。未发现晶状体混浊的患者。结论:NPC 放疗性角膜损伤与鼻咽癌临床分期及照射剂量无密切关系(P>0.05),可能主要与角膜感觉神经损伤导致眼表疾病密切相关;不排除患者不同个体对辐射的敏感差异性。
Objective: To investigate the nasopharyngeal carcinoma (NPC) radiation treatment of ocular complications. Methods: 213 cases of NPC primary radiotherapy patients were followed up. Radiotherapy before and after radiotherapy and radiotherapy for visual function (including far vision, slit lamp live microscope, fundus, automatic computer vision and evoked potential) examination and corneal fluorescein staining. Results: Corneal injury occurred in 19 cases, accounting for 8.9% (19/213). 6 cases of stage I ~ II, 8 cases of stage Ⅲ, 5 cases of stage Ⅳ. All patients had no symptoms of corneal irritation. Within 10 months after radiotherapy, the corneal lesions subsided, but the sensation was still significantly lower than that of the contralateral eye; but not returned to normal after 20 months. No lens opacity was found in the patient. CONCLUSION: The radiotherapy-induced corneal injury in NPC is not closely related to the clinical stage and irradiation dose of NPC (P> 0.05), but may be mainly related to the ocular surface disease caused by corneal sensory nerve injury. It is not excluded that the sensitivity of different individuals to radiation .