局部晚期鼻咽癌调强适形放疗中脑干放射耐受性的探讨

发布时间：2018-11-27 17:47

【摘要】：目的:观察局部晚期鼻咽癌(Nasopharyngeal Carcinoma, NPC)患者调强适形放射治疗(Intensity modulated radiation therapy,IMRT)脑干放射性毒副反应的发生,分析其影响因素。 资料与方法:观察2007年3月到2009年12月经病理确诊,并接受IMRT的初治局部晚期NPC患者46例,分析其靶区及危及器官的剂量体积直方图(dose volume histogram,DVH)。IMRT每天一次,2.2~2.4Gy/次,5次/周,处方剂量为69.8~76.1Gy(平均73.8Gy)。危及器官的限制剂量参照美国肿瘤放射治疗协会(Radiation Therapy Oncology Group,RTOG)0225号报告,尽可能地保护危及器官从而减少并发症的发生。 结果:4例患者(8.7%)出现脑干放射性毒副反应。脑干毒副反应的发生与脑干的最大剂量和V_(50)、V_(55)、V_(60)显著相关。多因素分析显示V_(60)是一个重要的影响因素。 结论:IMRT中的脑干放射耐受性与脑干受到高剂量照射的体积有关。对于局部晚期NPC患者,脑干V_(60)小于1.90cm~3可被临床接受。脑干受照体积的分析对于IMRT治疗的患者有其临床价值。
[Abstract]:Aim: to observe the adverse effects of brain stem radioactivity in patients with locally advanced nasopharyngeal carcinoma (Nasopharyngeal Carcinoma, NPC) treated with intensity modulated conformal radiotherapy (Intensity modulated radiation therapy,IMRT) and to analyze its influencing factors. Materials and methods: from March 2007 to December 2009, 46 patients with locally advanced NPC who were diagnosed by pathology and received IMRT from March 2007 to December 2009 were observed. The dose volume histogram (dose volume histogram,DVH). IMRT) of target area and organ was analyzed once a day. 2.2~2.4Gy/ times, 5 times a week, the prescription dose was 69.8~76.1Gy (average 73.8Gy). The limiting dose for organs, as reported by the American Cancer radiotherapy Association (Radiation Therapy Oncology Group,RTOG) No. 225, protects organs as much as possible and reduces complications. Results: 4 patients (8.7%) had side effects of brain stem radiation. The side effects of brain stem toxicity were significantly correlated with the maximum dose of brain stem and V50, V55, V60. Multivariate analysis shows that V _ (60) is an important factor. Conclusion: brain stem radiation tolerance in IMRT is related to the volume of brain stem exposed to high dose irradiation. Brainstem V _ (60) is less than 1.90cm~3 in patients with locally advanced NPC. The analysis of brainstem exposure volume has clinical value for patients treated with IMRT.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.63

【参考文献】

相关期刊论文 前10条

1 宋亭,梁碧玲,黄穗乔,谢榜昆,丁忠祥,沈君;鼻咽癌放疗后放射性脑干和脊髓损伤的磁共振表现[J];癌症;2005年03期

2 韩露;林少俊;潘建基;陈传本;张瑜;张秀春;廖希一;陈奇松;;305例鼻咽癌调强放疗预后因素分析[J];癌症;2010年02期

3 朱妍,回树新,郝继山,焦德让;放射性脑损伤的诊断[J];中华神经医学杂志;2005年04期

4 崔朝阳,程金妹,张鹏飞,李志春,易自翔,林昶,张榕,杨劲松;抑癌基因PTEN、P~(21wafl)在鼻咽癌中的表达及意义[J];耳鼻咽喉头颈外科;2003年02期

5 宋琼;夏黎明;;放射性脑损伤的磁共振波谱研究进展[J];放射学实践;2006年04期

6 孟庆勇;余永强;;放射性脑损伤的MRI研究进展[J];国际医学放射学杂志;2008年05期

7 高荣莲,陈肖华;星形胶质细胞的电离辐射损伤及修复作用[J];国外医学(放射医学核医学分册);2004年01期

8 钟静;姜恩海;;放射性脑损伤发病机制及免疫系统改变的研究[J];国际放射医学核医学杂志;2006年05期

9 陈艳芳;杨天恩;曹永珍;;放射性脑损伤和脑肿瘤复发的鉴别诊断[J];国际放射医学核医学杂志;2006年05期

10 樊锐太;郭艳娜;王敬敏;张洪志;顾浩;;同步放化疗综合治疗中晚期鼻咽癌的疗效观察[J];肿瘤基础与临床;2008年02期

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