| Background and objective:Head and neck cancer includes a series of tumors such as neck,ENT,oral and maxillofacial tumors,including various tumors such as nasopharyngeal cancer,laryngeal cancer,oropharyngeal cancer,oral cancer and salivary gland cancer.Nasopharyngeal cancer is the most common head and neck cancer in China.Due to its special anatomical location and sensitivity to radiation,radiotherapy is the radicallytreatment for patients with non-metastatic nasopharyngeal cancer.Other head and neck cancers,there are many treatment options such as surgery,radiotherapy,chemotherapy and so on.According to the different situations,surgery,radiotherapy and chemotherapy can be chosen properly.However,acute radiation treatment reactions caused by radichemotherapy),mainly including bone marrow suppression,acute oral mucositis,dermatitis,malnutrition and pain,can affect the patient's quality of life and its compliance with anti-tumor therapy so that they would interrupt or terminate radiotherapy and then affect the treatment effect.Although IMRT technology has greatly reduced the occurrence radiotherapy side effects,the prevalence of bone marrow suppression,acute radiotherapy reactions are still high.Recombinant human granulocyte stimulating factor,recombinant human interleukin-11 used after the occurrence of myelosuppression,but there are no drugpreventing the occurrence of myelosuppression.Radioactive oral mucositis using local and systemic corticosteroids treatments are available.According to the prevention and control of radioactive oral cavity mucositis strategy expert consensus(2019)points out that the local use of glucocorticoid(anti-inflammatory)can alleviate edema,inhibit inflammation,relieve clinical symptoms,with systemic corticosteroids has a tendency to reduce radiation interrupt,but local and systemic glucocorticoids treatment may cause adverse reactions.The composition of the Xihuang capsule is in vitro cultivation of bezoar,artificial musk,vinegar frankincense,vinegar myrrh,and it has anti-inflammatory,detoxification,and swelling and pain relief effects.It can also reduce bone marrow suppression in the treatment process of cancer such as lung cancer,esophageal cancer,colorectal cancer treatment.Methods:Review the data of patients with head and neck cancer recruited to the Oncology Department of Hunan Provincial People's Hospital from January 2017 to February 2020.Based on whether Xihuang capsules were used or not,122 patients were divided into the experimental group(with Xihuang capsules)and the control group(without Xihuang capsules),including 79 cases and 43 cases respectively.The usage of Xihuang Capsule is 1-1.5g per day,orally,twice a day.On the first day of radiotherapy,we used 0.9% sodium chloride gargle to maintain oral hygiene.If the radiotherapy reaction occurs during the radiotherapy,atomization inhalation,intravenous hormones,and intravenous antibiotics can be used to treat the radiotherapy response.If bone marrow suppression occurs,it can be treated symptomatically.Compare the experimental group with the control group in the times and days of atomization inhalation(including glucocorticoids and antibiotics),intravenous glucocorticoids,intravenous antibiotics and different grades of leukopenia,neutropenia,anemia,and thrombocytopenia,to further explore the therapeutic value of Xihuang capsule in the side effects of radiotherapy and chemotherapy for head and neck cancer.Therefore,it is of great significance to find ways to prevent the adverse reactions of radiotherapy and chemotherapy for head and neck cancer,reduce the interruption of radiotherapy and improve the therapeutic effect of patients.Results:1.A total of 58 patients(47.54%)did not develop neutropenia in among 122 patients.The percentage of grade 0-4 neutropenia in the observation group is 54.43%,24.05%,11.39%,7.59% and 2.53%,and the control group is 34.88%,13.95%,34.88%,11.63%,4.65%,The difference was statistically significant(P = 0.015).The incidence of neutropenia in the observation group(45.57%)was smaller than that in the control group(65.12%),and the difference was statistically significant(P = 0.039);Among patients with grade 1-4 neutropenia,the incidence of grade 2-4 neutropenia in the observation group(44.12%)was smaller than that in the control group(76.92%),and the difference was statistically significant(P = 0.011).2.The incidence of thrombocytopenia in the observation group(22.78%)was smaller than that in the control group(41.86%),and the difference was statistically significant(P = 0.024).The percentage of grade 0-3 thrombocytopenia in the observation group is 77.22%,15.19%,6.33%,1.27%,which was different from the control group 58.14%,9.30%,18.60%,13.95%,and the difference was statistically significant(P= 0.003).Among patients with thrombocytopenia,the incidence of grade2-3 thrombocytopenia in the observation group(33.33%)was smaller than that in the control group(77.78%),and the difference was statistically significant(P = 0.007).3.A total of 46(37.70%)did not develop anemia among 122 patients,and more than 50% of patients developed grade 1 and 2 anemia(43.44%,18.03%).Nobody developed grade 4 anemia.The incidence of anemia in the observation group(55.70%)was less than that in the control group(74.42%),and the difference was statistically significant(P = 0.042).4.There were 49 patients(62.03%)using atomization inhalation in the experimental group compared to 35 patients(81.40%)in the control group,and the difference was statistically significant(P = 0.027).The average days of usage of atomization inhalation in the experimental group who using atomization inhalation and the control group were 21.63 ±9.17,26.03 ± 10.41,and the difference was statistically significant(P =0.044).5.116 patients(95.08%)used venous hormones among the total patients included before,the usage rate of venous hormone(93.67%)in the experimental group was lower than that in the control group(97.67%),and the difference was no statistically significant(P = 0.423).Comparing the time for venous hormone usage between two groups and the average ranks were 52.06 and 69.86,respectively,and the difference was statistically significant(P = 0.006).6.The total number of patients using strong opioid analgesics was34(27.87%).The number of using strong opioids patient in the experimental group(21.52%)was significantly smaller than that in the control group(39.53%),and the difference was statistically significant(P= 0.034).7.There were 29 patients who used parenteral nutrition(23.77%).The proportion of patients using parenteral nutrition in the experimental group(13.92%)was significantly less than that in the control group(41.86%),and the difference was statistically significant(P = 0.001).Conclusions:1.Xihuang Capsule can reduce bone marrow suppression caused by head and neck cancer with radiotherapy and chemotherapy,and reduce the severity of bone marrow suppression.2.Xihuang capsule can reduce the use of anti-inflammatory,analgesic and parenteral nutrition supporting drugs during radiochemotherapy for head and neck cancer. |
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