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局部晚期鼻咽癌新辅助化疗后调强放疗靶区勾画及剂量分布

发布时间:2018-03-09 00:32

  本文选题:鼻咽癌 切入点:新辅助化疗 出处:《南昌大学》2011年硕士论文 论文类型:学位论文


【摘要】:背景与目的:本研究探讨新辅助化疗后大体肿瘤体积(Gross tumor volume,GTV)靶区勾画,观察此方式对靶区及正常组织剂量的影响。 方法:从2009年1月至2010年12月收治7例局部晚期鼻咽癌初治患者,采用TP新辅助化疗加同期调强放化疗方案进行治疗。按诱导化疗后肿瘤勾画靶区,其中临床靶区(CTV60)必须包括化疗前大体肿瘤范围。同时观察患者毒副反应和近期疗效。 结果:新辅助化疗前后原发灶GTV平均体积分别为38.9cm3和19.1cm3(P=0.001),新辅助化疗使肿瘤总体积平均减少了44%;诱导化疗前后计划靶区(PTV)剂量分布无统计学意义(P0.05);诱导化疗前后PTV70适形度指数(CI)分别为94.07±5.56及99.93±0.03(P=0.3),PTV70均匀性分别为0.16±0.02及0.13±0.01(P=0.5)。治疗结束后3个月鼻咽病灶和颈部淋巴结完全缓解率为85%。1年局部区域控制率85.7%。一例患者在13个月出现淋巴结复发。与同期化疗合并调强放疗相比,新辅助化疗后同期放化疗调强治疗毒性反应无明显增加。 结论:鼻咽癌TP方案新辅助化疗后肿瘤体积明显缩小,按诱导化疗后勾画GTV以及将肿瘤消退区剂量降低至60Gy,能使IMRT治疗时形成的高剂量区体积减少,并且维持较高的短期局部区域控制率,而同期放化疗不良反应未见加重。
[Abstract]:Background & AIM: in this study, we investigated the gross tumor volume gross tumor volume GTV target area after neoadjuvant chemotherapy, and observed the effects of this method on the dose of the target area and normal tissue. Methods: from January 2009 to December 2010, 7 patients with locally advanced nasopharyngeal carcinoma were treated with TP neoadjuvant chemotherapy plus simultaneous intensive radiation chemotherapy. The clinical target area CTV 60) must include the range of gross tumor before chemotherapy. Results: the mean volume of primary GTV before and after neoadjuvant chemotherapy was 38.9 cm ~ 3 and 19.1cm ~ (3) P ~ (-1), respectively. Neoadjuvant chemotherapy reduced the total tumor volume by 44% on average, and the dose distribution of planned target area before and after induction chemotherapy was not statistically significant (P 0.05). The PTV70 conformability index was 94.07 卤5.56 and 99.93 卤0.03 respectively. The uniformity of PTV70 was 0.16 卤0.02and 0.13 卤0.01P0. 5 respectively. 3 months after treatment, the complete remission rate of nasopharyngeal focus and cervical lymph node was 85.1 years local regional control rate was 85.7%. Compared with chemotherapy combined with IMRT, There was no significant increase in toxicity after neoadjuvant chemotherapy. Conclusion: after neoadjuvant chemotherapy for nasopharyngeal carcinoma (NPC) TP regimen, the tumor volume was significantly reduced. Drawing GTV after induced chemotherapy and reducing the dose of tumor regression area to 60 Gy could reduce the volume of high dose area formed during IMRT treatment. And maintained a high short-term local area control rate, while the adverse effects of radiotherapy and chemotherapy did not increase in the same period.
【学位授予单位】:南昌大学
【学位级别】:硕士
【学位授予年份】:2011
【分类号】:R739.63

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