鼻咽癌常规放疗与调强放疗远期并发症及疗效的临床研究

发布时间：2018-09-04 19:18

【摘要】：背景及目的：鼻咽癌通过单纯放疗或同步放化疗取得了相当好的局部控制率和生存率，生存期的延长，使放疗后的远期损伤和患者的生存质量越来越受放疗医师的关注。本文比较鼻咽癌不同放疗方式的远期并发症发生情况及远期疗效,为临床医师和患者进行放疗方式的选择提供参考资料。方法：采用门诊随访、电话随访、随访信等方式，调查自2003年1月至2006年7月在我院行放射治疗的145例鼻咽癌患者，分析不同放疗方式各远期并发症发生率及远期疗效。其中常规放疗68例，调强放疗77例。随访的远期并发症包括口干、张口受限、放射性龋齿、听力下降、颈部纤维化、放射性脑病等。结果：调强放疗组的颈部纤维化的发生率，放射性龋齿的发生率及严重程度，，放射性脑病的发生率，放疗后1年、2年、3年、4年、5年口干及张口受限的发生率及严重程度均明显优于常规放疗；听力下降的发生率两组无统计学意义。常规放疗组和调强放疗组5年生存率分别为60.5%、77.4%（χ2=4.320,p=0.038）。结论：鼻咽癌调强放疗远期并发症的发生率低于常规放疗，远期疗效明显优于常规放疗，但调强放疗仍存在部分远期并发症，影响患者的生存质量。
[Abstract]:Background and objective: nasopharyngeal carcinoma (NPC) has achieved a good local control rate and survival rate through radiotherapy alone or concurrent radiotherapy and chemotherapy. The survival time is prolonged. The long-term injury and quality of life of patients after radiotherapy have been paid more and more attention by radiotherapy physicians. In order to provide reference for clinicians and patients to choose radiotherapy methods, the long-term complications and long term effects of different radiotherapy methods for nasopharyngeal carcinoma were compared. Methods: 145 patients with nasopharyngeal carcinoma who received radiotherapy in our hospital from January 2003 to July 2006 were investigated by means of outpatient follow-up telephone follow-up and follow-up letter. Routine radiotherapy was performed in 68 cases and intensity modulated radiotherapy in 77 cases. Long-term complications include dry mouth, limited mouth opening, radioactive caries, hearing loss, cervical fibrosis, radiation encephalopathy, etc. Results: the incidence of cervical fibrosis, the incidence and severity of radioactive caries, the incidence of radiation encephalopathy, the incidence of cervical fibrosis in IMRT group, The incidence and severity of dry mouth and mouth opening were significantly higher than that of conventional radiotherapy in 1, 2, 3, 4, 5 years after radiotherapy, but the incidence of hearing loss was not statistically significant in the two groups. The 5-year survival rate of conventional radiotherapy group and intensity modulated radiotherapy group was 60.5% and 77.4% respectively (蠂 2 = 4.320 p0. 038). Conclusion: the incidence of long-term complications of intensity modulated radiotherapy for nasopharyngeal carcinoma is lower than that of conventional radiotherapy, and the long-term effect is obviously better than that of conventional radiotherapy. However, there are still some long-term complications in intensity modulated radiotherapy, which affect the quality of life of patients.
【学位授予单位】：济南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R739.63

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