鼻咽癌下颈锁骨上区照射中间设置V形铅挡块的临床观察  

Radiotherapy with Middle Conformal Lead Block at the Lower Cervical Supraclavicular Field for Nasopharyngeal Carcinoma

作　　者：陈建章[1] 尤传文[1] 刘金平[1] 陈雷[1] 

机构地区：[1]南京鼓楼医院集团宿迁市人民医院肿瘤科,江苏宿迁223800

出　　处：《肿瘤基础与临床》2012年第5期404-406,共3页journal of basic and clinical oncology

摘　　要：目的观察鼻咽癌下颈锁骨上区照射中间设置V形铅块挡喉、气管和脊髓的疗效和毒副反应。方法 134例患者鼻咽部原发灶和上、中颈区采用面颈联合野6 MV-X线照射36～40 Gy后,鼻咽部原发灶区采用15 MV-X线上、中颈10～12 MeV电子线野补量。下颈锁骨上区采用下颈锁骨上切线野6 MV-X线照射,中间设置"V"形铅块挡喉、气管和脊髓。结果 134例患者近期疗效,CR 130例,PR 4例,有效率100.0%。1、2、3、5 a生存率分别为98.2%、93.8%、84.9%和80.0%。下颈锁骨上切线野照射"V"形挡铅区域内,无颈部纤维化硬变,也均未见复发或转移病灶。结论鼻咽癌的放疗中,在下颈锁骨上切线野照射中间用"V"形铅块挡喉、气管和脊髓,颈部软组织纤维化硬变范围大大减少,患者的生活质量明显提高。Objective To observe the effect of middle conformal lead block at the lower cervical supraclavicular field in the protection of larynx,trachea and spinal cord in the radiotherapy for nasopharyngeal carcinoma. Methods The 6 MV-X rays were used at the nasopharynx primary lesions and the upper and middle cervical fields of 134 patients with nasopharyngeal carcinoma, the irradiation dosage was 40-60 Gy, and the 10-12 MeV electron rays were used for added exposure. The 6 MV-X rays were used at the lower cervical supraclavicular field for nasopharyngeal carcinoma, and the middle conformal lead block was used to protect the larynx,trachea and spinal cord. Results Ofall the 134 cases,CR was observed in the 130 cases,and PR in the 4 cases,the response rate was 100.0%. The 1-, 2-, 3-,5- year survival rates were 98.2% ,93.8 % , 84.9% , 80.0% , respectively. In the middle conformal lead block field, no neck hard fibrosis was observed,and no recurrence or metastatic lesions were observed. Conclusion The middle conformal lead block at the lower cervical snpraclavicular field can protect the larynx, trachea and spinal cord in the radiotherapy of nasopharyngeal carcinoma, can lessen the neck hard fibrosis, and improve the quality of life of the patients.

关 键 词：鼻咽癌 放疗 V形铅挡 

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