CAJ | 학술논문

调强放疗（intensity-modulated radiotherapy，IMRT）正逐步取代传统放疗成为鼻咽癌（nasopharyngeal carcinoma，NPC）的主流根治手段，既能提高肿瘤相关区域放疗剂量，又能降低正常器官和组织的受照剂量和体积，具有明显优势。但IMRT过程中，除系统误差和摆位误差外，鼻咽原发病灶和颈部转移淋巴结逐渐缩小、患者体质量逐渐减轻及体表外轮廓逐渐改变，也可导致NPC靶区和重要器官的照射剂量和体积出现“偏差”，影响IMRT的精确性。不少学者采用自适应放疗（adaptive radiotherapy， ART）修正鼻咽癌IMRT过程中由于肿瘤缩小、体质量减轻和外轮廓改变产生的“偏差”，结果显示ART具有一定的可行性，能够修正部分由肿瘤、体质量和外轮廓变化导致的“偏差”。
조강방료（intensity-modulated radiotherapy，IMRT）정축보취대전통방료성위비인암（nasopharyngeal carcinoma，NPC）적주류근치수단，기능제고종류상관구역방료제량，우능강저정상기관화조직적수조제량화체적，구유명현우세。단IMRT과정중，제계통오차화파위오차외，비인원발병조화경부전이림파결축점축소、환자체질량축점감경급체표외륜곽축점개변，야가도치NPC파구화중요기관적조사제량화체적출현“편차”，영향IMRT적정학성。불소학자채용자괄응방료（adaptive radiotherapy， ART）수정비인암IMRT과정중유우종류축소、체질량감경화외륜곽개변산생적“편차”，결과현시ART구유일정적가행성，능구수정부분유종류、체질량화외륜곽변화도치적“편차”。
Intensity-modulated radiotherapy (IMRT) is gradually replacing conventional radiation therapy and has become the mainstream radical treatment for patients with nasopharyngeal carcinoma (NPC). IMRT can conform and increase radiation doses to tu-mor-associated regions as well as decrease exposure doses and volumes on normal organs and tissues to avoid damage on critical or-gans. Aside from system and setup errors, other factors, such as the gradual reduction of the primary NPC lesion and the decrease in vol-ume of involved neck lymph nodes as well as body weight loss and changes in the head and neck shape during IMRT, may cause devia-tions in the radiation doses and volume delivered to the NPC targets and the organs at risk. These factors may affect the accuracy of IMRT. Several researchers have attempted to correct such deviations during IMRT for NPC patients by using adaptive radiotherapy (ART). The results indicate that ART is feasible to a certain degree and can correct the deviations, including decrease in tumor volume, body weight loss, and changes in head and neck shape of NPC patients.