45例鼻咽癌调强放射治疗联合同步化疗初步临床分析

发布时间：2018-07-02 14:13

本文选题：调强放射治疗 + 鼻咽癌　；参考：《浙江大学》2010年硕士论文

【摘要】： [目的]探讨鼻咽癌调强放射治疗(intensity-modulated radiotherapy, IMRT)联合化疗的初步疗效及治疗相关毒性。 [材料和方法]系统回顾分析浙江大学医学院附属第一医院放疗中心2007年10月至2009年6月病理确诊,无远处转移,并完成根治性放疗的初诊鼻咽癌患者45例。所有患者均具有治疗前增强MRI或者增强CT,同时行模拟CT定位扫描。采用同步推量(SIB)技术,处方剂量分别为GTV(鼻咽部及颈部转移淋巴结肿瘤靶区)6976-7412cGy／32-34F,CTV1(临床靶区)6016cGy／32F,CTV2(颈部预防性淋巴结引流区)5264cGy／28F。同步化疗采用奈达铂或者顺铂80mg／m2,d1,d22,d43,放疗后一月后给予PF方案辅助化疗3疗程,其中奈达铂或者顺铂80mg／m2 d1,5-FU 720mg／(m2.d)civ 120h,化疗间隔4周。分析疗效及治疗副反应。 [结果]中位年龄57岁,其中80%(36例)为男性。中位随访时间13月。74%(33例)的患者临床分期为Ⅲ／Ⅳ期。1例鼻咽复发,2例骨转移,其中1例转移患者死亡；1年无局部复发生存率,无远处转移生存率和总生存率分别为97.8%,95.5%,97.8%。无治疗相关性死亡。同步化疗期间常见急性毒性为3级胃肠道反应和粘膜反应,各为44.4%和42.5%,2例患者同步化疗期间出现4级骨髓抑制,晚期放射损伤以2度口干为主,无3-4级晚期放疗损伤。 [结论]本中心SIB-IMRT联合化疗在初治鼻咽癌中获得了良好疗效,急性和晚期副反应多可耐受。
[Abstract]:[objective] to investigate the preliminary efficacy and therapeutic toxicity of intensity-modulated radiation therapy (IMRT) combined with chemotherapy for nasopharyngeal carcinoma (NPC). [materials and methods] 45 patients with nasopharyngeal carcinoma (NPC) who had been diagnosed pathologically from October 2007 to June 2009 in the radiotherapy Center of the first affiliated Hospital of Zhejiang University Medical College were retrospectively analyzed. All patients had enhanced MRI or enhanced CT before treatment, and simulated CT scanning was performed at the same time. The prescription doses were 6976-7412cGy / 32-34FCTV1 (clinical target area) 6016cGy / 32FN CTV2 (cervical preventive lymph node drainage area) 5264cGy / 28F, respectively. Three courses of adjuvant chemotherapy were given one month after radiotherapy with neidplatin or cisplatin 80 mg / m ~ 2 d ~ (-1) ~ d ~ (22) d ~ (43). The chemotherapy interval was 4 weeks after chemotherapy with neidaplatin or cisplatin 80mg/m2 d _ (1) 5-FU 720mg/ (m ~ 2 路d) civ for 120 h. The curative effect and side effects were analyzed. [results] the median age was 57 years, of which 80% (36 cases) were male. The median follow-up time was 13 months. 74% (33 cases). The clinical staging was 1. 1 cases of nasopharyngeal recurrence, 2 cases of bone metastasis, 1 case of death, 1 case of local recurrence, 97. 8% of distant metastasis and 97. 8% of the total survival rate, respectively. No treatment-related deaths. The common acute toxicity during concurrent chemotherapy was grade 3 gastrointestinal reaction and mucosal reaction, 44.4% and 42.5%, respectively, with bone marrow suppression of grade 4 during concurrent chemotherapy. Late radiation injury was mainly caused by 2 degree dry mouth, no grade 3-4 grade late radiotherapy injury. [conclusion] SIB-IMRT combined with chemotherapy is effective in primary nasopharyngeal carcinoma, and the acute and late side effects are more tolerable.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R739.63

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