【摘要】：目的比較鼻咽癌患者調強放射治療與常規(guī)二維放射治療的療效和急慢性反應。 方法系統(tǒng)分析2008年5月至2010年12月在福建醫(yī)科大學附屬第一醫(yī)院放射治療科同期常規(guī)放射治療及調強放射治療(IMRT)的初治鼻咽癌患者203例，分為IMRT組（103例）和常規(guī)放射治療組（100例）。常規(guī)放射治療鼻咽部劑量66～74Gy，腫大淋巴結64—68Gy，頸部預防劑量50-52Gy；調強放射治療設鼻咽大體腫瘤為GTVnx、頸部陽性淋巴結GTVnd，高危臨床靶體積CTV1和低危臨床靶體積CTV2：。PTVnx：70.08土1.81Gy，PTVnd：67.38土2.58Gy，PTVl：61.46土2.13Gy，，PTV2：54.12土2.04Gy，分31～33次照射。比較IMRT和常規(guī)放射治療患者的急性不良反應如口干、吞咽疼痛、吞咽困難、皮膚和黏膜反應等；晚期損傷中張口困難、肌肉/軟組織損傷等方面。 結果與常規(guī)組相比，IMRT組的急性不良反應有不同程度的減輕，口干、吞咽疼痛、吞咽困難、皮膚反應和黏膜反應等的發(fā)生率較低(P＜0.05)；晚期損傷中張口困難、肌肉/軟組織損傷無明顯差別。 結論相對于常規(guī)放射治療，IMRT技術能夠減輕急性不良反應，改善患者的生存質量。
[Abstract]:Objective to compare the efficacy and acute and chronic response of intensity modulated radiotherapy and conventional two-dimensional radiotherapy in patients with nasopharyngeal carcinoma. Methods from May 2008 to December 2010, 203 patients with nasopharyngeal carcinoma (NPC) who were treated with conventional radiotherapy and intensity modulated radiotherapy (IMRT) in the Department of radiotherapy, first affiliated Hospital of Fujian Medical University were analyzed systematically. The patients were divided into IMRT group (103 cases) and conventional radiotherapy group (100 cases). The dose of nasopharynx was 660.74 Gy, the enlarged lymph node 64-68 Gy, and the cervical preventive dose 50-52 Gy. Intensity modulated radiotherapy (IMRT) for nasopharyngeal gross neoplasms: GTVnx, neck positive lymph node GTVnd, high risk target volume CTV1 and low risk clinical target volume CTV2:.PTVnx:70.08 1. 81Gy: 67.38 鹵2.58Gy PTVl: 61.46 鹵2.13Gy PTV2: 54.12 鹵2.04Gy, 3133 exposures. The acute adverse reactions such as dry mouth, dysphagia, skin and mucosal reaction in patients with IMRT and conventional radiotherapy were compared. Results compared with the control group, the incidence of acute adverse reactions in the IMRT group was lower than that in the control group (P < 0.05), and the incidence of dry mouth, dysphagia, skin reaction and mucosal reaction was lower (P < 0.05), and it was difficult to open the mouth in the late stage injury. There was no significant difference in muscle / soft tissue injury. Conclusion compared with conventional radiotherapy, IMRT can alleviate acute adverse reactions and improve the quality of life of patients.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：博士
【學位授予年份】：2012
【分類號】：R739.63

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