鼻咽癌调强放疗与常规放疗患者生活质量初步观察

发布时间：2018-01-24 04:52

本文关键词： 鼻咽癌调强放射治疗不良反应生活质量　出处：《浙江大学》2011年硕士论文　论文类型：学位论文

【摘要】：背景和目的：鼻咽癌是我国南方地区最常见的肿瘤之一,治疗首选以放疗为主的综合治疗措施。调强放射治疗(IMRT)不仅能提高鼻咽癌的局部控制率和生存率,同时也改善了患者治疗后的生活质量(QOL)。本文比较了鼻咽癌患者调强放疗与常规放疗的急慢性反应和生活质量。方法：系统回顾了2008年8月到2010年9月在宁波市李惠利医院行常规放疗以及调强放射治疗(IMRT)的初治鼻咽癌患者91例,其中IMRT组35例,常规放疗(RT)组56例。常规放疗采用面颈联合野+颈切线野及耳前野+颈部电子线野,靶区剂量70Gy/2.0Gy/35次；IMRT组设定9个共面野,靶区剂量69.96Gy/2.12Gy/33次。比较IMRT和RT两组患者的急性毒性如口干、吞咽疼痛、皮肤和黏膜反应等；同时也比较了晚期放射损伤如吞咽困难、张口困难、甲状腺功能低下、视力及听力下降、皮肤损伤、皮下组织纤维化、脊髓炎和脑损伤等方面。结果： IMRT组与RT组的急性反应如口干、吞咽疼痛、吞咽困难、皮肤反应和黏膜反应的发生率差异均有统计学意义(χ2=85.73,56.03,26.58,69.28,55.99,P0.01),即IMRT组的急性不良反应较常规组均有不同程度的减轻；IMRT组患者晚期损伤中口干、吞咽困难、味觉改变、张口困难、皮肤损伤、皮肤纤维化发生等方面较RT组显著减轻,差异均有统计学意义(χ2=37.95,7.48,9.49,9.49,11.87,P0.05),而听力下降程度、视力损伤、脑损伤发生率等方面差异无统计学意义,可能与随访时间较短有关。结论：相对于常规放疗,IMRT技术能够减轻急性毒性,并减少晚期损伤发生率,从而改善患者的生活质量。
[Abstract]:Background and purpose: Nasopharyngeal carcinoma (NPC) is one of the most common tumors in southern China. IMRTT can not only improve the local control rate and survival rate of nasopharyngeal carcinoma (NPC), but also give priority to radiotherapy. The quality of life (QOL) of patients with nasopharyngeal carcinoma (NPC) after treatment was also improved. The acute and chronic response and quality of life (QOL) of patients with nasopharyngeal carcinoma (NPC) were compared with that of conventional radiotherapy. Methods: From August 2008 to September 2010, 91 patients with nasopharyngeal carcinoma (NPC) who were treated with conventional radiotherapy and IMRT in Li Huili Hospital of Ningbo City were reviewed systematically. There were 35 cases in IMRT group and 56 cases in conventional radiotherapy group. Target dose of 70 Gy / 2.0 Gy / 35; In IMRT group, 9 coplanar fields were set up with target dose of 69.96 Gy / 2.12 Gy / 33 times. The acute toxicity such as dry mouth and dysphagia were compared between IMRT group and RT group. Skin and mucosal reactions; At the same time, advanced radiation injury such as dysphagia, mouth opening difficulty, hypothyroidism, visual acuity and hearing loss, skin damage, subcutaneous fibrosis, myelitis and brain injury were compared. Results: The incidence of acute reactions such as dry mouth, dysphagia, dysphagia, skin reaction and mucosal reaction in IMRT group and RT group were significantly different (蠂 2, 85.73, 56.03). The acute adverse reactions in IMRT group were alleviated to some extent as compared with those in the normal group. In IMRT group, the middle mouth, dysphagia, taste change, mouth opening difficulty, skin injury and skin fibrosis were significantly alleviated compared with RT group. The difference was statistically significant (蠂 ~ 2 ~ 37.95 ~ 7.48 ~ 9.49 ~ 9.49 ~ 11.87% P _ 0.05), but hearing loss and visual impairment. There was no significant difference in the incidence of brain injury, which might be related to the shorter follow-up time. Conclusion: Compared with conventional radiotherapy, IMRT can reduce acute toxicity and reduce the incidence of late injury, thus improving the quality of life of patients.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.63

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