鼻咽癌患者螺旋断层放疗中靶区及腮腺体积变化  

Change of target and parotid gland volume in nasopharyngeal carcinoma patients during helical tomotherapy

作　　者：蓝玉玲[1] 冯林春[1] 路娜[1] 解传滨[1] 王运来[1] 蔡博宁[1] 

机构地区：[1]解放军总医院放疗科,北京100853

出　　处：《解放军医学院学报》2013年第2期126-129,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的观察鼻咽癌原发灶、颈部转移淋巴结以及腮腺体积在螺旋断层放疗(helical tomotherapy,HT)中的变化。方法回顾性分析我院2008年3月-2012年3月收治的77例初治鼻咽癌患者,接受螺旋断层放疗70Gy/33F,在放疗第20次时重新行CT定位及改野,比较两次定位中鼻咽部肿瘤及咽后淋巴结(GTVnx)、颈部转移淋巴结(GTVnd)及腮腺的体积变化。结果重新定位时GTVnx、GTVnd体积分别缩小了32.6%±20.7%、47.3%±21.9%,左、右侧腮腺体积分别缩小了33.4%±18.9%、33.5%±20.6%,体积缩小程度与其初始体积呈正相关性。不同T分期中两次CT定位GTVnx体积的差异均有统计学意义(P<0.001),T1、T2、T3、T4期GTVnx分别缩小(5.6±4.7)cm3、(12.6±12.3)cm3、(23.2±12.6)cm3和(23.3±20.0)cm3(χ2=15.31,P<0.005)。结论螺旋断层放疗中,鼻咽部病灶、颈部转移淋巴结以及腮腺体积均有明显缩小,T3、T4期肿瘤原发灶体积缩小较T1、T2期明显。建议在调强放疗后半程再次行CT定位并及时调整治疗计划。Objective To observe the volumes of original foci,lymph nodes and parotid gland in nasopharyngeal carcinoma（NPC） patients during helical tomotherapy（HT）.Methods Clinical data about 77 NPC patients admitted to our hospital from March 2008 to March 2012 were retrospectively analyzed.At the 20 times when the patients underwent HT at the dose of 70Gy in 33 fractions（70Gy/33F）,their NPC was located one more by CT scanning.The volumes of NPC original foci,retropharyngeal lymph nodes（GTVnx）,cervical lymph nodes（GTVnd）,and parotid glands were compared.Results The volumes of GTVnx and GTVnd decreased 32.6%±20.7% and 47.3%±21.9%,respectively.The volumes of left and right parotid glands decreased 32.6%±20.7% and 47.3%±21.9%,respectively.The decreased volumes were positively related with the initial volumes.The volume of GTVnx in different T stages was significantly different between the first and second CT locations（P0.001）.The volume of GTVnx in stages T1-T4 decreased（5.6±4.7） cm3,（12.6±12.3） cm3,（23.2±12.6） cm3 and（23.3±20.0） cm3,respectively（χ2=15.31,P0.005）.Conclusion The volumes of NPC original foci,cervical lymph nodes,and parotid gland are significantly smaller after HT.The volume of NPC original foci is significantly smaller in T3/T4 stage than in T1/ T2 stage.The tumor should be located once more by CT scanning and its treatment plan should be adjusted.

关 键 词：鼻咽癌 螺旋断层放疗 靶体积 腮腺体积 

分 类 号：R815[医药卫生—放射医学]