Effects Of Weight Loss And Radiotherapy Dose On Acute Radiation Dermatitis Of Head And Neck Malignant Tumors

Objective To investigate the relationship between the change of body surface area and the occurrence level of acute radiation dermatitis during the radiotherapy of head and neck malignant tumors,and the change of the average surface radiation dose of the skin in the course of II radiation therapy and the skin in the course of radiation treatment due to the change of body surface area.Compare.Method By recording the height and weight of patients with head and neck malignancies before radiotherapy,the patient’s head and neck skin status,the weekly patient weight during radiotherapy,the dose of radiotherapy received by the patient,the level of acute radiation dermatitis of the head and neck skin,and taking photos,Analyze the time point of the occurrence of acute radiation dermatitis,and compare and analyze the correlation between the percentage of weight loss and the dose of radiotherapy and the level of acute radiation dermatitis,find the node of the percentage of weight loss and high-level acute radiation dermatitis,and explore the possible causes of acute radiation dermatitis.By comparing the PTV dose size between the first and second course of the patient,the possible causes of acute radiation dermatitis were discussed from a metrological point of view.By detecting the patient before radiotherapy,(0 Gy),during radiotherapy(28 ~ 30 Gy),radiotherapy After(60 Gy)the protein levels of inflammatory factors TNF-α,IL-1,IL-6,IL-8 and IL-10 were changed,the possible inflammatory factors of acute radiation dermatitis were analyzed.Result(1)A total of 39 patients were included in the clinical analysis.All 39 patients developed first-level acute radiation dermatitis,and the occurrence time of first-level acute radiation dermatitis(N-39)was 2.93 ± 0.724 weeks.The node for the emergence of secondary acute dermatitis(N = 33)was 5 ± 0.866 weeks,and the node for the occurrence of tertiary acute radiation dermatitis(N = 7)was 5.86 ± 0.378 weeks.(2)The irradiation interval of the first grade acute radiation dermatitis is about 26.83 ± 6.585 Gy,the second grade dermatitis is about 44.20 ± 7.719 Gy,and the third grade dermatitis is about 53.08 ± 3.715 Gy.(3)The percentage of weight loss and radiation dose were significantly correlated with acute radiation dermatitis,with correlation coefficients of 0.579 and 0.832,respectively.(4)The percentage of weight loss of tertiary acute radiation dermatitis ranges from about 8.35 ± 3.181%.(5)With the increase of the percentage decrease in body surface,the average skin radiation dose calculated by the Ⅱ course radiotherapy plan using the Ⅰ course radiotherapy plan increased compared with the average skin skin dose calculated by the I course radiotherapy plan,p value = 0,but stratified study The larger the increase in percent weight loss,the larger the average skin dose.Conclusion(1)According to the estimated time range of acute radiation dermatitis,patients with primary acute radiation dermatitis usually have about 3 weeks,secondary acute radiation dermatitis usually have about 5 weeks,and tertiary acute radiation dermatitis usually have about 6 weeks.(2)The patient’s weight loss percentage was 1.783.05%,and the first-level acute radiation dermatitis occurred.The patient’s weight loss percentage was 5.293.99%,and the second-level acute radiation dermatitis occurred.The patient’s weight loss percentage was 8.353.18%,and the third-level acute radiation dermatitis occurred.Radiation dermatitis.As the percentage of weight loss increases,the level of acute radiation dermatitis increases,and body weight is positively correlated with the occurrence of acute radiation dermatitis.(3)As the radiation dose increased,the level of acute radiation dermatitis increased,and the radiation dose was positively correlated with the occurrence of acute radiation dermatitis.(4)According to the correlation coefficient analysis,the percentage of radiation dose over weight loss has a greater relationship with acute radiation dermatitis.However,due to the limited human intervention of radiation dose,controlling weight loss has become the focus of clinical guidance.(5)The occurrence of high-level(three and above)acute radiation dermatitis affects the quality of life of patients.It is concluded from the analysis of the percentage of weight loss that it is clinically recommended to control the percentage of weight loss below 8.35 ± 3.18%.When this range is close,Repositioning and new plans should be undertaken.(6)The percentage of weight loss increases.The average radiation dose of the skin calculated by the application of the radiation treatment plan for the second course of radiotherapy is increased compared with the average radiation dose of the skin calculated by the first course of radiation therapy.It is necessary to re-start when the weight loss is too large Location,but stratified studies did not yield positive results.