腮腺尺寸变化对初治鼻咽癌调强放疗病例脑干、脊髓剂量的影响  

Effect of parotid gland changes on doses of brain stem and spinal cord in initial intensity modulated radiotherapy for nasopharyngeal carcinoma

作　　者：王志伟[1] 段继梅[1] 谷丹[1] 岳麒[1] 杨秀美[1] 

机构地区：[1]昆明医科大学第一附属医院肿瘤放疗科,云南昆明650032

出　　处：《中国医学物理学杂志》2016年第5期533-537,共5页Chinese Journal of Medical Physics

摘　　要：目的:分析腮腺尺寸变化对初治鼻咽癌调强放疗病例脑干、脊髓剂量的影响。方法:选择10例初治鼻咽癌病例,采用自适应软件获取病人在第5、10、15、20、25、30次治疗时腮腺尺寸和脑干、脊髓剂量的变化情况。结果:第25次治疗时,10例病例的腮腺尺寸出现明显退缩,腮腺最大横径和前后径最大退缩率均超过30%。治疗期间有4例病例脑干、脊髓剂量变化与腮腺尺寸改变相关,最小、最大变化率出现在第30次治疗时,第2例病人的脊髓-D_(max)、第3例病人的脑干PRVD_(max)分别增加1.6%、5.38%。结论:初治鼻咽癌病例调强放疗期间,腮腺尺寸变化对脑干、脊髓剂量的影响值得重视。Objective To analyze the effect of parotid gland changes on the doses of brain stem and spinal cord in the initial intensity modulated radiotherapy for nasopharyngeal carcinoma. Methods Ten patients with primary nasopharyngeal carcinoma were selected. The adaptive radiotherapy software was applied to obtain the changes of parotid gland size, and the dosimetry variations of brain stem and spinal cord at the 5^th, 10^th, 15^th, 20^th, 25^th and 30^th fractions of treatment. Results The parotid gland size of ten patients shrank obviously at the 25^th fraction, and the maximum shrank rates of maximum transverse diameters and anteroposterior diameters exceeded 30%. During treatment, the dosimetry variations of brain stem and spinal cord of 4 patients were highly correlated with the changes of parotid gland size. When the 30^th fraction showed minimum and maximum changing rates, the spinal cord-D_（max）of patient NO.2 and the maximum dose（D_（max）） of planning organs at risk volume in brain stem of patient NO.3 respectively increased 1.6% and 5.38%. Conclusion The effect of parotid gland changes on the doses of brain stem and spinal cord in the initial intensity modulated radiotherapy for nasopharyngeal carcinoma should be given attention.

关 键 词：鼻咽癌 腮腺尺寸 脑干 脊髓 调强放疗 剂量学 

分 类 号：R811.1[医药卫生—放射医学]