鼻咽癌调强放疗的临床应用  

Intensify modulated radiotherapy for nasopharyngeal carcinoma

作　　者：卢渊全[1] 

机构地区：[1]河南省商丘市第一人民医院,商丘476100

出　　处：《中国实用医刊》2008年第19期10-11,共2页Chinese Journal of Practical Medicine

摘　　要：目的观察调强放疗（IMRT）鼻咽癌的临床疗效、急性反应和晚期损伤。方法对40例初治或复发鼻咽癌患者给予1MRT，将照射靶体积划分为鼻咽大体肿瘤体积（GTVnx）、颈部大体肿瘤体积（GTVnd）、临床靶体积1（CTV1）、临床靶体积2（CTV2）。处方剂量：GTVnx68—74Gy，GTVnd60～66Gy，CTV160Gy，CTV254Gy；共30次。32例接受放化综合治疗，8例接受单纯放疗。结果GTVnx、GTVnd、CTV1、CTV2的平均剂量分别为72．40、67．83、50．25和64．85Gv。中位随访期9个月，局部无进展生存率100％；1例放疗后4个月出现肝和肺转移。结论IMRT技术无论在早期或晚期鼻咽癌病例中均可获得理想的剂量分布，正常组织得到很好的保护，不良反应可以耐受，临床疗效令人满意。Objective To verify the efficiency of nasopharyngeal carcinoma（NPC） treated with intensity modulated radiation therapy（IMRT） and to observe the acute and late normal tissue toxicities. Methods Total of 40 cases of primary and recurrent nasopharyngeal carcinoma were treated with IMRT. The target volume was described as： the gross tumor volume of the nasopharynx （GTVnx） , the cervical lymph node （GTVnd） , the clinical volume （CTV1） , and the clinical volume （CTV2） , respectively, The prescribed dose to the GTVnx, GTVnd, CTV1, CTV2 were 68 -74,60 -66,60,54 Gy, respectively. Total fraction was 30, 32 patients had radiotheraphy combined with cisplatin based chemotherapy, whereas 8 patients were treated with radiotheraphy alone. Results The mean doses of GTVnx, GTVnd, CTV1, CTV2 were 72, 40,67, 83,60.25,64.85. With a median follow - up of 9 months, the local regional progression - free rate was 100% , one patient had metastasis in liver and lung. Conclusion Simultaneous modulated accelerated radiation therapy yields better dose distribution and acceptable toxicity than the traditional radiotherapy in both early and advanced stage nasopharyngeal carcinoma, The preliminary clinical result is encouraging.

关 键 词：鼻咽肿瘤 调强放射治疗 预后 

分 类 号：R739.63[医药卫生—肿瘤] R730.55[医药卫生—临床医学]