鼻咽癌放射治疗剂量与眼角膜内皮细胞减少关系  

The relationship between radiotherapy dose for nasopharyngeal carcinoma and corneal endothelial cell loss

作　　者：李晓峰[1] 李淑艳[1] 王君影[1] 王曙红[1] 张泉[1] 

机构地区：[1]南京医科大学附属淮安第一医院, 江苏223300

出　　处：《中国实用眼科杂志》2014年第7期836-839,共4页Chinese Journal of Practical Ophthalmology

基　　金：南京医科大学科技发展基金（2013NJMU224）

摘　　要：目的 评估鼻咽癌患者实施放射治疗的放射剂量与眼角膜内皮细胞减少的关系.方法 临床病例对照研究.回顾研究2007年1月至2009年12月就诊于南京医科大学附属淮安市第一医院行放射治疗的鼻咽癌患103例,根据放射剂量的不同分成四组,分别记录每组治疗前与治疗结束后1d、1周、1个月、6个月、1年、2年的眼角膜内皮细胞密度.通过分析放射治疗前后角膜内皮细胞数的变化,来评估放射剂量对角膜内皮细胞的影响.结果 各组患者的年龄差异比较无统计学意义（F=1.90,P=0.1353）.当放射剂量≤50Gy（A组和B组）,角膜内皮细胞数下降不明显,随访观察能恢复到治疗前水平;当放射剂量＞50Gy（C组和D组）,角膜内皮细胞数量明显减少,且不能恢复到治疗前水平.结论 角膜内皮细胞的减少与放射剂量有关,当放射剂量达到阈值后,角膜内皮细胞数开始减少,甚至发生严重的角膜病变.因此,做好角膜保护并积极给予临床预防和治疗,是非常必要的.Objective To evaluate the implementation between radiotherapy dose for NPC and corneal endothelial cell loss.Methods A retrospective study was made for 103 patients who had received radiation therapy for nasopharyngeal carcinoma between January 2007 and December 2009 in Huai＆#39;an First People＆#39;s Hospital,Nanjing Medical University.The patients were divided into four groups according to different radiation doses,and the corneal endothelial cell densities were recorded for each group before treatment and 1 day,1 week,1 month,6 months,1 year,and 2 years after treatment,the effects that radiation dose on corneal endothelial cells through analyzing the changes of corneal endothelial cell densities between pre-treatment and post-treatment were assessed.Results The difference of age was not statistically significant （F 1.90,P 0.1353）.The corneal endothelial cells was slightly reduced when the radiation dose was less than 50Gy （group A and B）,and which could be restored to the pre-treatment level during follow-up.The corneal endothelial cells was significantly reduced when the radiation dose was more than 50Gy （group C and D）,and which could be restored to the pre-treatment level during follow-up.Conclusions Reduction in corneal endothelial cells associated with radiation dose,when the threshold of radiation dose is reached,the corneal endothelial cells begin to reduce,or even evolved severe corneal disease,so corneal protection and actively prevention and treatment is very necessary.

关 键 词：鼻咽癌 放射治疗 角膜内皮细胞 

分 类 号：R735.1[医药卫生—肿瘤]