鼻咽癌调强放射治疗对唾液腺功能的保护作用  

Salivary gland function of nasopharyngeal cancer patients treated by simultaneous modulated accelerated radiation therapy

作　　者：张琦[1] 李焕斌[1] 王玲[1] 吴式锈[2] 谢聪颖[2] 

机构地区：[1]温州医学院核医学教研室,温州325027 [2]温州医学院附属第一医院放射治疗科,温州325027

出　　处：《核技术》2007年第9期773-776,共4页Nuclear Techniques

摘　　要：本文利用唾液腺动态显像研究鼻咽癌加速调强放射治疗对唾液腺功能的保护作用。对46例鼻咽癌患者作肿瘤和肿大淋巴结行同步加速调强放射治疗（SMART）,GTV定义为2.5Gy/次,共28次,肿瘤量70Gy;PTV定义为2.0Gy/次,共28次,肿瘤量56Gy;每天照射1次,每周5次;采用静态调强方式（Stepandshoot）进行。14例鼻咽癌患者例行常规放射治疗。放射治疗前后均行唾液腺功能显像,计算腮腺、颌下腺的摄取指数、酸性刺激后分泌指数及流率,对腺体功能损伤情况进行分析;同时记录病人口干程度并分级。结果表明,SMART组腮腺和颌下腺的摄取指数、分泌指数和流率均显著高于常规放射治疗组（P〈0.05）。常规放射治疗病人都出现不同程度的口干,并伴有口腔粘膜糜烂,1级口干仅1例,2、3级分别为3、10例;SMART组14例均无口干,1、2级口干分别为18、9例,3级口干仅为5例。两组间口干程度差异有显著统计学意义（χ^2=23.52,P〈0.005）。鉴此,鼻咽癌加速调强放射治疗对唾液腺功能有较明显的保护作用。The work was to study protective effect of simultaneous modulated accelerated radiation therapy （SMART） on salivary function of nasopharyngeal cancer patients. Forty-six patients were treated by SMART with 2.5Gy/fraction at gross tumor volume to a total does of 70 Gy, and 2.0 Gy/fraction at the clinical treatment volume to a total does of 56 Gy. The SMART was practiced in step-and-shoot mode, one time a day, and five times each week. Fourteen patients were treated by conventional radiation therapy. All the patients received salivary gland function imaging for their uptake index, excretive index and excretive speed, so as to evaluate their degree of salivary function injury. Meanwhile, the dry discomfort in mouth of the patients was recorded and classified. The results showed that the functional indexes of the SMART group were significantly higher than those of the conventional radiation therapy group （P〈0.05）. The 14 patients treated by conventional radiation therapy showed xerostomia and mucositis, with only one patient in Grade 1, three in Grade 2 and 10 in Grade 3. The patients in SMART group felt much better, withl4 of no xerostomia, 18 in Grade 1, 9 in Grade 2, and just 5 in Grade 3. The difference between the two groups is obvious （χ^2 =23.52, P〈0.005）. Therefore, SMART can play a key role in protecting salivary gland function of naso- pharyngeal cancer patients.

关 键 词：鼻咽癌 加速调强放射治疗 唾液腺SPECT显像 ^99)Tc^mO4^- 

分 类 号：R817.492[医药卫生—影像医学与核医学]