中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2011年
6期
680-683
,共4页
鼻咽癌%调强放射治疗%不良反应%生存质量
鼻嚥癌%調彊放射治療%不良反應%生存質量
비인암%조강방사치료%불량반응%생존질량
Nasopharyngeal carcinoma%Intensity-modulated radiotheraspy%Adverse events%Quality of life
目的 比较鼻咽癌患者调强放疗与常规放疗的急慢性反应和生存质量.方法 系统分析2008年8月至2010年9月在宁波市李惠利医院行常规放疗及调强放射治疗(IMRT)的初治鼻咽癌患者91例,分为IMRT组(35例)和常规放疗组(56例).常规放疗采用面颈联合野+颈切线野及耳前野+颈部电子线野,靶区剂量2.0 Gy/次,35次,共70 Gy;调强放疗设定9个共面野,靶区剂量2.12 Gy/次,33次,共69.96 Gy.比较IMRT和常规放疗患者的急性不良反应如口干、吞咽疼痛、吞咽困难、皮肤和黏膜反应等；晚期放射损伤如吞咽困难、张口困难、甲状腺功能低下、视力及听力下降、皮肤损伤、皮下组织纤维化、脊髓炎、脑损伤等方面.结果 与常规组相比,IMRT组的急性不良反应有不同程度的减轻,口干、吞咽疼痛、吞咽困难、皮肤反应和黏膜反应等的发生率较低(x2=85.73、56.03、26.58、69.28和55.99,P＜0.05)；晚期损伤中口干、吞咽困难、味觉改变、张口困难、皮肤损伤等方面显著减轻(x2=37.95、7.48、9.49、9.49和11.87,P＜0.05),而听力下降程度、视力损伤、脑损伤等的发生率差异无统计学意义,可能与随访时间较短有关.结论 相对于常规放疗,IMRT技术能够减轻急性不良反应,并减少晚期损伤发生率,改善患者的生存质量.
目的 比較鼻嚥癌患者調彊放療與常規放療的急慢性反應和生存質量.方法 繫統分析2008年8月至2010年9月在寧波市李惠利醫院行常規放療及調彊放射治療(IMRT)的初治鼻嚥癌患者91例,分為IMRT組(35例)和常規放療組(56例).常規放療採用麵頸聯閤野+頸切線野及耳前野+頸部電子線野,靶區劑量2.0 Gy/次,35次,共70 Gy;調彊放療設定9箇共麵野,靶區劑量2.12 Gy/次,33次,共69.96 Gy.比較IMRT和常規放療患者的急性不良反應如口榦、吞嚥疼痛、吞嚥睏難、皮膚和黏膜反應等；晚期放射損傷如吞嚥睏難、張口睏難、甲狀腺功能低下、視力及聽力下降、皮膚損傷、皮下組織纖維化、脊髓炎、腦損傷等方麵.結果 與常規組相比,IMRT組的急性不良反應有不同程度的減輕,口榦、吞嚥疼痛、吞嚥睏難、皮膚反應和黏膜反應等的髮生率較低(x2=85.73、56.03、26.58、69.28和55.99,P＜0.05)；晚期損傷中口榦、吞嚥睏難、味覺改變、張口睏難、皮膚損傷等方麵顯著減輕(x2=37.95、7.48、9.49、9.49和11.87,P＜0.05),而聽力下降程度、視力損傷、腦損傷等的髮生率差異無統計學意義,可能與隨訪時間較短有關.結論 相對于常規放療,IMRT技術能夠減輕急性不良反應,併減少晚期損傷髮生率,改善患者的生存質量.
목적 비교비인암환자조강방료여상규방료적급만성반응화생존질량.방법 계통분석2008년8월지2010년9월재저파시리혜리의원행상규방료급조강방사치료(IMRT)적초치비인암환자91례,분위IMRT조(35례)화상규방료조(56례).상규방료채용면경연합야+경절선야급이전야+경부전자선야,파구제량2.0 Gy/차,35차,공70 Gy;조강방료설정9개공면야,파구제량2.12 Gy/차,33차,공69.96 Gy.비교IMRT화상규방료환자적급성불량반응여구간、탄인동통、탄인곤난、피부화점막반응등；만기방사손상여탄인곤난、장구곤난、갑상선공능저하、시력급은력하강、피부손상、피하조직섬유화、척수염、뇌손상등방면.결과 여상규조상비,IMRT조적급성불량반응유불동정도적감경,구간、탄인동통、탄인곤난、피부반응화점막반응등적발생솔교저(x2=85.73、56.03、26.58、69.28화55.99,P＜0.05)；만기손상중구간、탄인곤난、미각개변、장구곤난、피부손상등방면현저감경(x2=37.95、7.48、9.49、9.49화11.87,P＜0.05),이은력하강정도、시력손상、뇌손상등적발생솔차이무통계학의의,가능여수방시간교단유관.결론 상대우상규방료,IMRT기술능구감경급성불량반응,병감소만기손상발생솔,개선환자적생존질량.
Objective To compare the acute and late adverse events and quality of life (QOL) in patients with nasopharyngeal carcinomas receiving conventional external beam radiation therapy (RT) versus intensity modulated radiation therapy (IMRT).Methods Ninety-one patients with newly diagnosed nasopharyngeal carcinoma treated in our institution between August 2008 and September 2010 were systemically reviewed,including 35 cases administered with conventional RT ( RT group) and 56 cases with IMRT (IMRT group).Conjoint facio-cervical fields plus tangential lower neck-supraclavicular field initially,and then shrinking preauricular portals plus electron beams to the neck were adopted in RT groups,with a total dose of 70 Gy/35 fractions.Nine coplanar fields were conducted in IMRT group with a total dose of 69.96 Gy/33 fractions.Acute and late adverse reactions were observed and compared between RT and IMRT groups,including acute reactions as xerostomia,odynophagia,dermatitis/mucositis and late events as dysphagia,trismus,hypothyroidism,optic/acoustic impairments,skin injury,hypodermal fibrosis,spinal myelitis and brain injury.Results Compared with RT group,IMRT group showed less acute reactions in xerostomia,odynophagia,dysphagia and dermatitis and mucositis(x2 =85.73,56.03,26.58,69.28,55.99,P ＜ 0.05 ),and less late reactions in xerostomia,dysphagia,trismus,taste loss and skin injury (x2 =37.95,7.48,9.49,9.49,11.87,P ＜ 0.05 ),whereas the degree of acoustic/optic impairments and brain injury showed no difference in both groups.Conclusions As compared to conventional RT,IMRT could decrease acute and some late side events,and improve the quality of life in patients with nasopharyngeal carcinoma.
