鼻咽癌放射性脑损伤35例分析  

Analysis of 35 Cases with Brain Damage Following Radiotherapy for Nasopharyngeal Carcinoma

作　　者：廖遇平[1] 洪继东[1] 王学伟[1] 姜武忠[1] 涂青松[1] 章正[1] 

机构地区：[1]中南大学湘雅医院放疗科,湖南长沙410008

出　　处：《医学临床研究》2004年第1期36-38,共3页Journal of Clinical Research

摘　　要：【目的】探讨鼻咽癌放疗后放射性脑损伤的原因、临床特点和预防措施。【方法】收集 35例鼻咽癌放疗后放射性脑损伤患者 ,对放射治疗的方法、耳前野上界、放疗剂量及颈部纤维化与脑损伤之间的关系进行回顾性分析。【结果】放射性脑损伤患者存在不同程度的颈部放射性纤维化 ,影响脑的血液供应 ;投照剂量越高 ,放射后时间越长 ,则纤维化越明显。 16例CT增强扫描提示脑损伤侧大脑中动脉增粗不均。【结论】血管损伤是鼻咽癌放射性脑损伤的重要病理基础之一 ,使用面颈联合野 ,合理降低耳前野上界 ,应用三维适形放疗 ,特别对复发再治患者采用超分割放疗将会降低放射性脑病的发生率。[Objectives]To investigate causes,clinical characteristics and preventive methods of brain damage following radiotherapy for nasopharyngeal carcinoma.A series of 35 cases with clinically confirmed brain damage after radiotherapy for nasopharyngeal cancer,their methods of radiotherapy,upper border of preauricle fields,dose of radiotherapy and fibrosis in the neck were retrospectively reviewed. In patients with brain damage after radiotherapy, fibrosis of various degrees in the neck influenced blood distribution,the more dose was given and the longer time was after radiotherapy, the more serious fibrosis would occur in the neck.In 16 cases, CT intensity scan showed irregular enlarged brain artery in the disease side.[Conclusion]Blood vessel injury is an important base in pathology for brain damage following radiotherapy for nasopharyngeal carcinoma,It would decrease the rate of brain damage following radiotherapy to use face-neck combining field,to moderately lower upper border of preauricle fields,to adopt three-dimensional conformal radiation therapy,and especially for the recurrent patients receiving further radiation therapeutical courses to use hyperfractionation.

关 键 词：鼻咽癌 放射性脑损伤 预防 放射治疗 诊断 

分 类 号：R739.6[医药卫生—肿瘤] R818.81[医药卫生—临床医学]