【摘要】：背景及目的：鼻咽癌通過(guò)單純放療或同步放化療取得了相當(dāng)好的局部控制率和生存率，生存期的延長(zhǎng)，使放療后的遠(yuǎn)期損傷和患者的生存質(zhì)量越來(lái)越受放療醫(yī)師的關(guān)注。本文比較鼻咽癌不同放療方式的遠(yuǎn)期并發(fā)癥發(fā)生情況及遠(yuǎn)期療效,為臨床醫(yī)師和患者進(jìn)行放療方式的選擇提供參考資料。 方法：采用門診隨訪、電話隨訪、隨訪信等方式，調(diào)查自2003年1月至2006年7月在我院行放射治療的145例鼻咽癌患者，分析不同放療方式各遠(yuǎn)期并發(fā)癥發(fā)生率及遠(yuǎn)期療效。其中常規(guī)放療68例，調(diào)強(qiáng)放療77例。隨訪的遠(yuǎn)期并發(fā)癥包括口干、張口受限、放射性齲齒、聽力下降、頸部纖維化、放射性腦病等。 結(jié)果：調(diào)強(qiáng)放療組的頸部纖維化的發(fā)生率，放射性齲齒的發(fā)生率及嚴(yán)重程度，，放射性腦病的發(fā)生率，放療后1年、2年、3年、4年、5年口干及張口受限的發(fā)生率及嚴(yán)重程度均明顯優(yōu)于常規(guī)放療；聽力下降的發(fā)生率兩組無(wú)統(tǒng)計(jì)學(xué)意義。常規(guī)放療組和調(diào)強(qiáng)放療組5年生存率分別為60.5%、77.4%（χ2=4.320,p=0.038）。 結(jié)論：鼻咽癌調(diào)強(qiáng)放療遠(yuǎn)期并發(fā)癥的發(fā)生率低于常規(guī)放療，遠(yuǎn)期療效明顯優(yōu)于常規(guī)放療，但調(diào)強(qiáng)放療仍存在部分遠(yuǎn)期并發(fā)癥，影響患者的生存質(zhì)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.
【學(xué)位授予單位】：濟(jì)南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R739.63

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