适形调强放疗对鼻咽肿瘤退缩模式的影响  

Influence of intensity-modulated radiotherapy on tumor regression in nasopharyngeal carcinoma

作　　者：韩非 肖巍魏 王汉渝 黄莹 邓美玲 赵充 卢泰祥 

机构地区：[1]肿瘤学国家重点实验室,510060

出　　处：《中华放射医学与防护杂志》2012年第2期204-206,共3页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的 回顾性分析适形调强放疗（IMRT）对鼻咽肿瘤退缩模式的影响。方法 选取2001年4月至2007年12月间接受单纯放疗初治鼻咽癌患者,其中,IMRT 196例,常规放疗76例。IMRT组照射总疗程平均为6周,常规放疗组总疗程平均为7周。结果 放疗结束时,IMRT组的鼻咽肿瘤和颈部淋巴结残留率分别为36.7%和44.2%,高于常规放疗组的 21.1%和26.6%（χ^2=6.15 和 3.99, P＜0.05）。放疗后3个月,IMRT组有6.1%残留,常规放疗组有9.2%残留,两组差异无统计学意义。IMRT组残留病灶在放疗后4~9个月时完全消退。结论 采用IMRT治疗初治鼻咽癌,肿瘤的退缩模式与常规放疗不同。IMRT结束时,肿瘤残留率较高,但只要靶区剂量充足,不宜盲目追加剂量。Objective To retrospectively analyze the influence of intensity-modulated radiotherapy （IMRT） on tumor regression in primary nasopharyngeal carcinoma （NPC）. Methods 272 patients with NPC received radical radiotherapy alone, 196 by IMRT with a total treatment time of 6 weeks, and 76 by bilateral field conventional radiotherapy （CRT） with the total treatment time of 7 weeks. Results By the end of radiotherapy, the primary tumor and neck lymph node residual rates of the IMRT group were 36.7% and 44.2%, respectively, both significantly higher than those of the CRT group（21.1% and 26.6%, χ2=6.15, 3.99,P〈0.05）. Three months after the radiotherapy, residual lesions were observed at the nasopharynx or neck lymph nodes in 12 of the IMRT group, with a residual rate of 6.1%, not significantly different from that of the CRT group （9.2%, 7/76）. The 12 residual lesions of the IMRT group all vanished completely 4-9 months after the radiotherapy. Conclusions There is an obvious difference in regressive mode between IMRT and CRT technique in NPC treatment. At the end of IMRT, the tumor residual rate is slightly increased. However, the delivered dose of gross tumor volume （GTV） is sufficient, and the boost dose should not be delivered indiscreetly.

关 键 词：鼻咽癌 适形调强放疗 常规放疗 肿瘤退缩模式 放射生物效应 

分 类 号：R739.63[医药卫生—肿瘤]