鼻咽癌常规外照射致后组颅神经损伤的危险因素研究  

Risk factors of conventional irradiation-induced lower cranial neuropathy in patients with nasopharyngeal carcinoma

作　　者：潘建基[1] 洪金省[2] 张瑜[1] 

机构地区：[1]福建医科大学教学医院,福建省肿瘤医院放疗科,350014 [2]福建医科大学附属第一医院放疗科

出　　处：《中华放射医学与防护杂志》2006年第5期490-493,共4页Chinese Journal of Radiological Medicine and Protection

基　　金：福建省科技计划资助项目(2000Z040)

摘　　要：目的探讨鼻咽癌常规放疗后放射性后组颅神经损伤(RILCN)的危险因素,以指导鼻咽癌放疗计划的制定。方法采用1∶2配对的病例对照研究,回顾性分析100对接受根治性放射治疗的鼻咽癌患者,应用条件Logistic回归模型分析可能影响RILCN形成的因素。结果选入回归方程的因素有吸烟、照射方法、上颈部照射剂量、颈部纤维化和颈部皮肤急性放射毒性,其危险度比分别为4·594、2·629、1·072、4·141和2·531。结论吸烟、照射方法、上颈部照射剂量、颈部纤维化和颈部皮肤急性放射毒性是RILCN发生的危险因素。建议停用耳前野加全颈切线野的照射方式。Objective To study the risk factors of radiation-induced lower cranial neuropathy （RILCN） after conventional radiotherapy in patients with nasopharyngeal carcinoma, and to improve the radiotherapeutic planning. Methods A hundred cases received radical radiotherapy of nasopharyngeal carcinoma and 200 individual matched controls on sex, age and time to start the radiotherapy were studied. Conditional logistic regression model was used to analyze 13 risk factors related to development of RILCN. Results Conditional logistic regression analysis revealed that cigarette smoking, irradiation scheme, radiation dose to the superior neck, neck fibrosis and acute radiation-related dermatitis of neck were risk factors of RILCN, their relative risks were 4.594, 2.629, 1.072, 4.141 and 2.531, respectively. Among three external irradiation schemes, it is found that pre-auricular portal plus whole neck tangential portal irradiation had the highest risk of RILCN. Conclusions The study suggested that the irradiation scheme of pre-auricular portal plus whole neck tangential portal should be no longer used.

关 键 词：鼻咽肿瘤 放射治疗 辐射损伤 颅神经疾病 

分 类 号：R739.63[医药卫生—肿瘤]