医学临床研究
醫學臨床研究
의학림상연구
JOURNAL OF CLINICAL RESEARCH
2014年
8期
1497-1499
,共3页
放射疗法 ,调强适形/方法%鼻咽肿瘤/放射疗法%随机对照试验%治疗结果
放射療法 ,調彊適形/方法%鼻嚥腫瘤/放射療法%隨機對照試驗%治療結果
방사요법 ,조강괄형/방법%비인종류/방사요법%수궤대조시험%치료결과
Radiotherapy,Intensity-Modulated/MT%Nasopharyngeal Neoplasms/RT%Randomized Controlled T rial%T reatment Outcome
【目的】通过对局部晚期鼻咽癌调强适形放射治疗（IM RT ）分阶段两次设计治疗计划的剂量学比较，探讨两次IM RT计划的必要性及可行性。【方法】选取本院50例局部晚期鼻咽癌患者为研究对象，随机分成两组，试验组和对照组，每组各25例。两组患者均先行诱导化疗2～4个疗程后行IM RT放疗，试验组采用两次IM RT计划设计，对照组则采用一次性IM RT 计划设计。观察比较两组患者的靶区及周围敏感器官剂量变化。【结果】对照组患者的双侧腮腺的平均剂量（Dmean）和超出限量体积占腮腺总体积的30％比例（V30）均明显高于试验组，且两组相比较差异有显著性（ P ＜0．05）；对照组患者的脑干和脊髓的Dmax及脑干总体积50％比例（V50）和脊髓总体积40％比例（V40）均明显高于试验组，且两组相比较差异有显著性（ P＜0．05）。【结论】采用两次IM RT计划治疗局部晚期鼻咽癌对于确保靶区的剂量和保证正常组织剂量、更有效地保护腮腺功能及脑干和脊髓等重要器官具有一定的优势。
【目的】通過對跼部晚期鼻嚥癌調彊適形放射治療（IM RT ）分階段兩次設計治療計劃的劑量學比較，探討兩次IM RT計劃的必要性及可行性。【方法】選取本院50例跼部晚期鼻嚥癌患者為研究對象，隨機分成兩組，試驗組和對照組，每組各25例。兩組患者均先行誘導化療2～4箇療程後行IM RT放療，試驗組採用兩次IM RT計劃設計，對照組則採用一次性IM RT 計劃設計。觀察比較兩組患者的靶區及週圍敏感器官劑量變化。【結果】對照組患者的雙側腮腺的平均劑量（Dmean）和超齣限量體積佔腮腺總體積的30％比例（V30）均明顯高于試驗組，且兩組相比較差異有顯著性（ P ＜0．05）；對照組患者的腦榦和脊髓的Dmax及腦榦總體積50％比例（V50）和脊髓總體積40％比例（V40）均明顯高于試驗組，且兩組相比較差異有顯著性（ P＜0．05）。【結論】採用兩次IM RT計劃治療跼部晚期鼻嚥癌對于確保靶區的劑量和保證正常組織劑量、更有效地保護腮腺功能及腦榦和脊髓等重要器官具有一定的優勢。
【목적】통과대국부만기비인암조강괄형방사치료（IM RT ）분계단량차설계치료계화적제량학비교，탐토량차IM RT계화적필요성급가행성。【방법】선취본원50례국부만기비인암환자위연구대상，수궤분성량조，시험조화대조조，매조각25례。량조환자균선행유도화료2～4개료정후행IM RT방료，시험조채용량차IM RT계화설계，대조조칙채용일차성IM RT 계화설계。관찰비교량조환자적파구급주위민감기관제량변화。【결과】대조조환자적쌍측시선적평균제량（Dmean）화초출한량체적점시선총체적적30％비례（V30）균명현고우시험조，차량조상비교차이유현저성（ P ＜0．05）；대조조환자적뇌간화척수적Dmax급뇌간총체적50％비례（V50）화척수총체적40％비례（V40）균명현고우시험조，차량조상비교차이유현저성（ P＜0．05）。【결론】채용량차IM RT계화치료국부만기비인암대우학보파구적제량화보증정상조직제량、경유효지보호시선공능급뇌간화척수등중요기관구유일정적우세。
To explore the necessity and feasibility of twice intensity modulated radiation thera-py(IMRT ) plans for locally advanced nasopharyngeal carcinoma through the dosiology comparison of IMRT therapy plan by stages for twice .[Methods]A total of 50 patients with locally advanced nasopharyngeal carci-noma were chosen as the research objects and randomly divided into experimental group and control group with 25 patients in each group .The patients in two groups were treated by chemotherapy for 2~4 periods ,and then IMRT radiotherapy .The experimental group was given twice IMRT plan design ,while the control group was given once IMRT plan design .The dose changes of target area and the surrounding sensitive organs in two groups were observed and compared .[Results] Mean dose(Dmean) and V30 of bilateral parotid in control group were obviously higher than those in experimental group ,and there was significant difference between two groups( P <0 .05) .Dmax and V50 of brain stem and spinal cord in control group were obviously higher than those in experimental group ,and there was significant difference between two groups ( P<0 .05) .[Con-clusion]The twice IMRT plans for the treatment of locally advanced nasopharyngeal carcinoma have a certain advantage for ensuring radiation dose of target area and normal tissue dose and protecting parotid function and important organs such as brain stem and spinal cord effectively .
