本文選題：鼻咽腫瘤/放射療法 + 調(diào)強(qiáng)適形放射治療�。� 參考：《中華腫瘤防治雜志》2014年23期

【摘要】：目的探討初治鼻咽癌患者接受調(diào)強(qiáng)適形放射治療(intensity modulated radiation therapy,IMRT)引起顳葉放射性損傷(temporal lobe necrosis,TLN)的發(fā)生情況并分析其相關(guān)危險(xiǎn)因素。方法回顧性分析2006-01-01-2008-06-30中山大學(xué)腫瘤防治中心288例接受IMRT根治性放療的初治鼻咽癌患者發(fā)生TLN的情況,并分析了患者性別、年齡、T分期、誘導(dǎo)化療、同時(shí)期化療、輔助化療、聯(lián)合化療、鼻咽照射總劑量、鼻咽照射分次劑量、后裝治療、糖尿病或高血壓病、肝病、吸煙、顳葉最大劑量和平均劑量與TLN發(fā)生的關(guān)系,進(jìn)一步采用Logistic回歸進(jìn)行多因素分析TLN的獨(dú)立危險(xiǎn)因素,并用Kaplan-Meier法分析了具有不同獨(dú)立危險(xiǎn)因素的患者累積無顳葉損傷生存情況。結(jié)果 288例患者中有33例(11.5%)出現(xiàn)TLN;576側(cè)顳葉中有41例(7.1%)出現(xiàn)TLN。TLN潛伏時(shí)間為17~70個(gè)月,中位時(shí)間36個(gè)月。ROC曲線分析顯示,本組患者顳葉最大劑量分界點(diǎn)為65.85Gy,顳葉平均劑量分界點(diǎn)為15.42Gy;Logistic回歸分析證實(shí)T分期、顳葉最大劑量和平均劑量是鼻咽癌放療后TLN獨(dú)立危險(xiǎn)因素。T4、顳葉最大劑量≥65.85Gy及平均劑量≥15.42Gy的患者3年及5年累積無顳葉損傷生存率均顯著低于低風(fēng)險(xiǎn)的患者,P均0.001。結(jié)論 T4、顳葉最大劑量≥65.85Gy和平均劑量≥15.42Gy是鼻咽癌IMRT后發(fā)生TLN的危險(xiǎn)因素。
[Abstract]:Objective to investigate the incidence of radiation injury of temporal lobe (temporal lobe necrosis) induced by intensity modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC) and to analyze its risk factors. Methods the incidence of TLN in 288 patients with nasopharyngeal carcinoma (NPC) undergoing IMRT radical radiotherapy was retrospectively analyzed in the Cancer Prevention and treatment Center of Sun Yat-sen University from January to June 2006.The patients' sex, age, T stage, induced chemotherapy, chemotherapy at the same time and adjuvant chemotherapy were analyzed. Combined chemotherapy, total dose of nasopharyngeal irradiation, fractional dose of nasopharyngeal irradiation, afterloading therapy, diabetes or hypertension, liver disease, smoking, maximum dose and average dose of temporal lobe were associated with the occurrence of TLN. Logistic regression was used to analyze the independent risk factors of TLN, and Kaplan-Meier method was used to analyze the survival of patients with different independent risk factors. Results among 288 patients, 33 cases (11.5%) had TLN.TLN latency of 17 ~ 70 months (41 / 576), and the median time was 36 months. ROC curve analysis showed that TLN.TLN occurred in 41 (7.1%) of the 576 sides of temporal lobe. The maximum dose boundary point of temporal lobe was 65. 85 Gy, and the mean dose boundary point of temporal lobe was 15. 42 Gym logistic regression analysis to confirm T stage. The maximum dose and average dose of temporal lobe were independent risk factors of TLN after radiotherapy. The survival rates of patients with temporal lobe maximum dose 鈮，

本文編號(hào)：2052521