CAJ | 학술논문

目的：探讨三维适形放疗对鼻咽癌放疗后颞颌关节的损伤。方法选取86例鼻咽癌患者分为观察组与对照组，各43例。观察组采用调强放射治疗（IMRT），对照组则采用三维适形放疗（3D-CRT）技术治疗。对比2组患者放疗的整体效果，颞颌关节照射情况及其受损发生率。结果随访2年后观察组颞颌关节受损总发生率为18．6％（8/43），且均为轻度受损；对照组受损总发生率为30．2％（13/43），其中重性受损发生率为4．7％（2/43）。观察组平均照射剂量及33％体积的照射剂量相对于对照组更少。结论三维适形放疗相对于调强放射治疗，对患者的颞颌关节损伤更大，因此，有条件者应以强调放疗为首选。
목적：탐토삼유괄형방료대비인암방료후섭합관절적손상。방법선취86례비인암환자분위관찰조여대조조，각43례。관찰조채용조강방사치료（IMRT），대조조칙채용삼유괄형방료（3D-CRT）기술치료。대비2조환자방료적정체효과，섭합관절조사정황급기수손발생솔。결과수방2년후관찰조섭합관절수손총발생솔위18．6％（8/43），차균위경도수손；대조조수손총발생솔위30．2％（13/43），기중중성수손발생솔위4．7％（2/43）。관찰조평균조사제량급33％체적적조사제량상대우대조조경소。결론삼유괄형방료상대우조강방사치료，대환자적섭합관절손상경대，인차，유조건자응이강조방료위수선。
Objective To Explore the three-dimensional conformal radiotherapy for temporomandibular joint damage of nasopharyngeal carcinoma after radiotherapy .Methods 86 cases of nasopharyngeal carcinoma patients were randomly divided in -to the observation group and the control group ,each with 43 cases.The observation group received intensity modulated radiation therapy (IMRT),the control group received three-dimensional conformal radiotherapy (3D-CRT).The overall effects,tem-poromandibular joint irradiation damage and its incidence rates of the 2 groups were compared .Results After 2-year follow-up, overall incidence rate of temporomandibular joint damage of the observation group was 18.6% (8/43),and all were mildly im-paired;overall incidence rate of temporomandibular joint damage of the control group was 30.2% (13/43),in which the severe damage occurred was 4.7%(2/43).The mean radiation dose and 33%of all dose volume of the observation group were less than that of the control group .Conclusion Three-dimensional conformal radiotherapy compared with intensity modulated radiation therapy has greater temporomandibular joint damage ,and IMRT should be the first radiotherapy choice .