影像引导调强放射治疗鼻咽癌  

Image guided intensity-modulated radiotherapy for the treatment of nasopharyngeal carcinoma

作　　者：张艳玲[1] 邹岚[1] 肖红[1] 黄海辉[1] 谭崇富[1] 阮志华[1] 王希[1] 梁后杰[1] 庞学利[1] 

机构地区：[1]重庆第三军医大学西南医院肿瘤科400038

出　　处：《临床肿瘤学杂志》2009年第1期51-54,共4页Chinese Clinical Oncology

摘　　要：目的：探讨调强放疗技术（IMRT）治疗鼻咽癌的近期疗效、毒副反应及技术特点。方法：采用影像引导的sliding windows动态调强技术对31例鼻咽癌初治患者进行根治性放疗，分30-33次照射。靶区处方剂量GTVnx、GTVnd、CTV1、CTV2分别为70-76Gy、68-70Gy、60-66Gy和54Gy，同时对脑干、腮腺等重要器官给予剂量限制保护。结果：随访3-18个月，中位随访时间10个月，患者1年局部区域无进展生存率、无远处转移生存率和总生存率分别为93．5％、87．1％和93．5％。急性放射反应多为Ⅰ度和Ⅱ度，以口干和放射性口腔炎为主，未观察到Ⅳ度急性反应。DVH分析显示IMRT提高了靶体积照射总剂量和分次剂量，减少了危及器官受照总剂量和分次剂量。结论：调强放射治疗鼻咽癌能够取得良好的近期疗效，明显减轻了急性放射反应，患者生活质量得到改善，值得推广应用和深入研究。To explore the efficacy of image guided intensity-modulated radiotherapy（IMRT） in the treatment of na- sopharyngeal carcinoma. Methods ： Thirty-one patients with pathologically confirmed squamous cell carcinoma of nasopharynx were treated with image guided IMRT. The prescribed doses of GTVnx, GTVnd, CTV1 and CTV2 were 70-76Gy, 68-70Gy, 60-66Gy and 54Gy respectively. The overall survival and local control rates were calculated with kaplan-meier method. Acute side effects were also evaluated. Results：The median follow-up time was 10 months （range 3-18 months）. The 1-year estimated local-regional progression-free survival rates, distant metastases-free survival rates and overall survival rates were 93.5%, 87. 1% and 93.5% respectively. Most acute radiation toxicity was grade I to grade II and was presented as xerostomia and mucositis, no grade Ⅳ acute radiation toxicity occured. The anaysis of dose volume histogram shows that IMRT provided satisfied dose distribution to the target volume and sparing of normal structures significantly. Conclusion：The image guided IMRT technique can provided satisfied dose distribution with high dose to the target volume and sparing of organ at risk. The excellent local control rate was achieved with significant decrease of acute toxicity.

关 键 词：鼻咽肿瘤 放射疗法 调强放射疗法 

分 类 号：R739.6[医药卫生—肿瘤] R730.55[医药卫生—临床医学]