本文關(guān)鍵詞： 鼻咽癌 調(diào)強(qiáng)放射治療 不良反應(yīng) 生活質(zhì)量　出處：《浙江大學(xué)》2011年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：背景和目的： 鼻咽癌是我國(guó)南方地區(qū)最常見(jiàn)的腫瘤之一,治療首選以放療為主的綜合治療措施。調(diào)強(qiáng)放射治療(IMRT)不僅能提高鼻咽癌的局部控制率和生存率,同時(shí)也改善了患者治療后的生活質(zhì)量(QOL)。本文比較了鼻咽癌患者調(diào)強(qiáng)放療與常規(guī)放療的急慢性反應(yīng)和生活質(zhì)量。 方法： 系統(tǒng)回顧了2008年8月到2010年9月在寧波市李惠利醫(yī)院行常規(guī)放療以及調(diào)強(qiáng)放射治療(IMRT)的初治鼻咽癌患者91例,其中IMRT組35例,常規(guī)放療(RT)組56例。常規(guī)放療采用面頸聯(lián)合野+頸切線野及耳前野+頸部電子線野,靶區(qū)劑量70Gy/2.0Gy/35次；IMRT組設(shè)定9個(gè)共面野,靶區(qū)劑量69.96Gy/2.12Gy/33次。比較IMRT和RT兩組患者的急性毒性如口干、吞咽疼痛、皮膚和黏膜反應(yīng)等；同時(shí)也比較了晚期放射損傷如吞咽困難、張口困難、甲狀腺功能低下、視力及聽(tīng)力下降、皮膚損傷、皮下組織纖維化、脊髓炎和腦損傷等方面。 結(jié)果： IMRT組與RT組的急性反應(yīng)如口干、吞咽疼痛、吞咽困難、皮膚反應(yīng)和黏膜反應(yīng)的發(fā)生率差異均有統(tǒng)計(jì)學(xué)意義(χ2=85.73,56.03,26.58,69.28,55.99,P0.01),即IMRT組的急性不良反應(yīng)較常規(guī)組均有不同程度的減輕；IMRT組患者晚期損傷中口干、吞咽困難、味覺(jué)改變、張口困難、皮膚損傷、皮膚纖維化發(fā)生等方面較RT組顯著減輕,差異均有統(tǒng)計(jì)學(xué)意義(χ2=37.95,7.48,9.49,9.49,11.87,P0.05),而聽(tīng)力下降程度、視力損傷、腦損傷發(fā)生率等方面差異無(wú)統(tǒng)計(jì)學(xué)意義,可能與隨訪時(shí)間較短有關(guān)。 結(jié)論： 相對(duì)于常規(guī)放療,IMRT技術(shù)能夠減輕急性毒性,并減少晚期損傷發(fā)生率,從而改善患者的生活質(zhì)量。
[Abstract]:Background and purpose: Nasopharyngeal carcinoma (NPC) is one of the most common tumors in southern China. IMRTT can not only improve the local control rate and survival rate of nasopharyngeal carcinoma (NPC), but also give priority to radiotherapy. The quality of life (QOL) of patients with nasopharyngeal carcinoma (NPC) after treatment was also improved. The acute and chronic response and quality of life (QOL) of patients with nasopharyngeal carcinoma (NPC) were compared with that of conventional radiotherapy. Methods: From August 2008 to September 2010, 91 patients with nasopharyngeal carcinoma (NPC) who were treated with conventional radiotherapy and IMRT in Li Huili Hospital of Ningbo City were reviewed systematically. There were 35 cases in IMRT group and 56 cases in conventional radiotherapy group. Target dose of 70 Gy / 2.0 Gy / 35; In IMRT group, 9 coplanar fields were set up with target dose of 69.96 Gy / 2.12 Gy / 33 times. The acute toxicity such as dry mouth and dysphagia were compared between IMRT group and RT group. Skin and mucosal reactions; At the same time, advanced radiation injury such as dysphagia, mouth opening difficulty, hypothyroidism, visual acuity and hearing loss, skin damage, subcutaneous fibrosis, myelitis and brain injury were compared. Results: The incidence of acute reactions such as dry mouth, dysphagia, dysphagia, skin reaction and mucosal reaction in IMRT group and RT group were significantly different (蠂 2, 85.73, 56.03). The acute adverse reactions in IMRT group were alleviated to some extent as compared with those in the normal group. In IMRT group, the middle mouth, dysphagia, taste change, mouth opening difficulty, skin injury and skin fibrosis were significantly alleviated compared with RT group. The difference was statistically significant (蠂 ~ 2 ~ 37.95 ~ 7.48 ~ 9.49 ~ 9.49 ~ 11.87% P _ 0.05), but hearing loss and visual impairment. There was no significant difference in the incidence of brain injury, which might be related to the shorter follow-up time. Conclusion: Compared with conventional radiotherapy, IMRT can reduce acute toxicity and reduce the incidence of late injury, thus improving the quality of life of patients.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類(lèi)號(hào)】：R739.63

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