鼻咽癌调强放疗后张口困难的临床观察  

Clinical analysis of IMRT-induced Temporomandibular Joint Lesion in Patients with Nasopharyngeal Carcinoma

作　　者：尹宏[1] 向舫[1] 朱苏雨[1] 罗英[1] 

机构地区：[1]湖南省肿瘤医院,湖南长沙410013

出　　处：《现代临床医学》2010年第1期21-23,共3页Journal of Modern Clinical Medicine

摘　　要：目的:比较鼻咽癌患者调强放疗和常规放疗后张口困难的情况。方法:将74例鼻咽癌患者分为常规放疗组41例和调强放疗组33例。常规放疗采用面颈联合野、耳前野、鼻前野照射,总剂量70～74Gy。调强放疗采用7个野照射,总剂量69.4～74.8Gy。放疗前以及放疗后1年用直尺测量上下门齿最大间距。结果:调强放疗组门齿距从放疗前的4.03±0.47cm缩小至放疗后1年的3.61±0.81cm,明显好于常规放疗组(P<0.01);张口困难的发生率为9.4%,明显低于常规放疗组55.6%(P<0.01)。结论:调强放疗使颞颌关节受照剂量显著下降,放疗后张口困难发生率较常规放疗明显降低。Objective：To compare the Radiation-induced prismns in nasopharyngeal carcinoma patients treated with IMRT to that with conventional radiotherapy.Methods：Seventy four nasopharyngeal carcinoma patients were treated with conventional radiotherapy（41 cases） and IMRT（33 cases）.Bilateral facial-neck fields were adopted as the main fields with conventional radiotherapy,the total dose ranged from 70 to 74 Gy.7 conformal fields were adopted with IMRT,the total dose ranged from 69.4 to 74.8 Gy.The distance between 2 dens incisivus medialis （DDIM） was measured before radiotherapy,and 1 year after radiotherapy.Results：The calculated DDIM was 4.03 ± 0.47 cm before RT,and 3.61 ± 0.81 cm 1 year post-RT with IMRT,which was better than that with conventional RT（P 0.01）;The ratio of prismns with IMRT was 9.4%,which was much lower than that with conventional RT（P 0.01）.Conclusion：IMRT can spare the temporomandibular joint from high dose irradiation.The risk of radiation-induced severe temporomandibular joint damage,namely prismns in NPC patients treated with IMRT is much lower than with conventional radiotherapy.

关 键 词：鼻咽癌 调强适形放射治疗 颞颌关节 放射晚期损伤 

分 类 号：R739.63[医药卫生—肿瘤]