【摘要】：目的:觀察局部晚期鼻咽癌(Nasopharyngeal Carcinoma, NPC)患者調(diào)強(qiáng)適形放射治療(Intensity modulated radiation therapy,IMRT)腦干放射性毒副反應(yīng)的發(fā)生,分析其影響因素。 資料與方法:觀察2007年3月到2009年12月經(jīng)病理確診,并接受IMRT的初治局部晚期NPC患者46例,分析其靶區(qū)及危及器官的劑量體積直方圖(dose volume histogram,DVH)。IMRT每天一次,2.2~2.4Gy/次,5次/周,處方劑量為69.8~76.1Gy(平均73.8Gy)。危及器官的限制劑量參照美國腫瘤放射治療協(xié)會(Radiation Therapy Oncology Group,RTOG)0225號報告,盡可能地保護(hù)危及器官從而減少并發(fā)癥的發(fā)生。 結(jié)果:4例患者(8.7%)出現(xiàn)腦干放射性毒副反應(yīng)。腦干毒副反應(yīng)的發(fā)生與腦干的最大劑量和V_(50)、V_(55)、V_(60)顯著相關(guān)。多因素分析顯示V_(60)是一個重要的影響因素。 結(jié)論:IMRT中的腦干放射耐受性與腦干受到高劑量照射的體積有關(guān)。對于局部晚期NPC患者,腦干V_(60)小于1.90cm~3可被臨床接受。腦干受照體積的分析對于IMRT治療的患者有其臨床價值。
[Abstract]:Aim: to observe the adverse effects of brain stem radioactivity in patients with locally advanced nasopharyngeal carcinoma (Nasopharyngeal Carcinoma, NPC) treated with intensity modulated conformal radiotherapy (Intensity modulated radiation therapy,IMRT) and to analyze its influencing factors. Materials and methods: from March 2007 to December 2009, 46 patients with locally advanced NPC who were diagnosed by pathology and received IMRT from March 2007 to December 2009 were observed. The dose volume histogram (dose volume histogram,DVH). IMRT) of target area and organ was analyzed once a day. 2.2~2.4Gy/ times, 5 times a week, the prescription dose was 69.8~76.1Gy (average 73.8Gy). The limiting dose for organs, as reported by the American Cancer radiotherapy Association (Radiation Therapy Oncology Group,RTOG) No. 225, protects organs as much as possible and reduces complications. Results: 4 patients (8.7%) had side effects of brain stem radiation. The side effects of brain stem toxicity were significantly correlated with the maximum dose of brain stem and V50, V55, V60. Multivariate analysis shows that V _ (60) is an important factor. Conclusion: brain stem radiation tolerance in IMRT is related to the volume of brain stem exposed to high dose irradiation. Brainstem V _ (60) is less than 1.90cm~3 in patients with locally advanced NPC. The analysis of brainstem exposure volume has clinical value for patients treated with IMRT.
【學(xué)位授予單位】：廣西醫(yī)科大學(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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