本文選題：鼻咽癌　切入點：新輔助化療　出處：《南昌大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：背景與目的：本研究探討新輔助化療后大體腫瘤體積(Gross tumor volume,GTV)靶區(qū)勾畫,觀察此方式對靶區(qū)及正常組織劑量的影響。 方法：從2009年1月至2010年12月收治7例局部晚期鼻咽癌初治患者,采用TP新輔助化療加同期調(diào)強放化療方案進行治療。按誘導(dǎo)化療后腫瘤勾畫靶區(qū),其中臨床靶區(qū)(CTV60)必須包括化療前大體腫瘤范圍。同時觀察患者毒副反應(yīng)和近期療效。 結(jié)果：新輔助化療前后原發(fā)灶GTV平均體積分別為38.9cm3和19.1cm3(P=0.001),新輔助化療使腫瘤總體積平均減少了44%；誘導(dǎo)化療前后計劃靶區(qū)(PTV)劑量分布無統(tǒng)計學(xué)意義(P0.05)；誘導(dǎo)化療前后PTV70適形度指數(shù)(CI)分別為94.07±5.56及99.93±0.03(P=0.3),PTV70均勻性分別為0.16±0.02及0.13±0.01(P=0.5)。治療結(jié)束后3個月鼻咽病灶和頸部淋巴結(jié)完全緩解率為85%。1年局部區(qū)域控制率85.7%。一例患者在13個月出現(xiàn)淋巴結(jié)復(fù)發(fā)。與同期化療合并調(diào)強放療相比,新輔助化療后同期放化療調(diào)強治療毒性反應(yīng)無明顯增加。 結(jié)論：鼻咽癌TP方案新輔助化療后腫瘤體積明顯縮小,按誘導(dǎo)化療后勾畫GTV以及將腫瘤消退區(qū)劑量降低至60Gy,能使IMRT治療時形成的高劑量區(qū)體積減少,并且維持較高的短期局部區(qū)域控制率,而同期放化療不良反應(yīng)未見加重。
[Abstract]:Background & AIM: in this study, we investigated the gross tumor volume gross tumor volume GTV target area after neoadjuvant chemotherapy, and observed the effects of this method on the dose of the target area and normal tissue. Methods: from January 2009 to December 2010, 7 patients with locally advanced nasopharyngeal carcinoma were treated with TP neoadjuvant chemotherapy plus simultaneous intensive radiation chemotherapy. The clinical target area CTV 60) must include the range of gross tumor before chemotherapy. Results: the mean volume of primary GTV before and after neoadjuvant chemotherapy was 38.9 cm ~ 3 and 19.1cm ~ (3) P ~ (-1), respectively. Neoadjuvant chemotherapy reduced the total tumor volume by 44% on average, and the dose distribution of planned target area before and after induction chemotherapy was not statistically significant (P 0.05). The PTV70 conformability index was 94.07 鹵5.56 and 99.93 鹵0.03 respectively. The uniformity of PTV70 was 0.16 鹵0.02and 0.13 鹵0.01P0. 5 respectively. 3 months after treatment, the complete remission rate of nasopharyngeal focus and cervical lymph node was 85.1 years local regional control rate was 85.7%. Compared with chemotherapy combined with IMRT, There was no significant increase in toxicity after neoadjuvant chemotherapy. Conclusion: after neoadjuvant chemotherapy for nasopharyngeal carcinoma (NPC) TP regimen, the tumor volume was significantly reduced. Drawing GTV after induced chemotherapy and reducing the dose of tumor regression area to 60 Gy could reduce the volume of high dose area formed during IMRT treatment. And maintained a high short-term local area control rate, while the adverse effects of radiotherapy and chemotherapy did not increase in the same period.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R739.63

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