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
2014年
1期
34-36
,共3页
鼻咽癌%咽后淋巴结%淋巴结坏死%淋巴结转移%调强放疗
鼻嚥癌%嚥後淋巴結%淋巴結壞死%淋巴結轉移%調彊放療
비인암%인후림파결%림파결배사%림파결전이%조강방료
Nasopharyngeal carcinoma%Retropharyngeal lymph node%Necrosis of lymph node%Metastasis of lymph node%Intensity modulated radiotherapy
目的 探讨鼻咽癌咽后淋巴结阳性率和坏死率与临床疗效的关系,为制定综合治疗方案提供参考.方法 选取2004年8月至2007年3月接受调强放疗的72例鼻咽癌患者,在CT定位图像上勾画咽后淋巴结及坏死区,计算坏死区体积,分析咽后淋巴结阳性率及坏死率与临床相关因素的关系.结果 颈部淋巴结转移率为90.3％,其中,I区转移率为2.8％,Ⅱ区为86.0％,Ⅲ区为51.4％,Ⅳ区为20.8％,Ⅴ区为37.5％.咽后淋巴结转移率为79.2％,咽后淋巴结交叉转移率为6.9％.咽后淋巴结阳性者中,左侧出现坏死占21.6％,右侧出现坏死占27.2％,双侧均出现坏死占15.4％.咽后淋巴结转移与N分期和临床分期有明显相关性(福州92分期,r =0.383、-0.314,P＜0.05;UICC分期,r=-0.434、-0.306,P ＜0.05).中位随访时间36个月,4例出现复发,6例出现远处转移,死亡7例.咽后淋巴结阳性与复发率、远处转移率及生存率、无病生存率明显相关(r=0.085、0.138、-0.140、-0.124,P＜0.05);咽后淋巴结坏死与复发率、远处转移率相关(r=0.256、-0.057,P＜0.05),与生存率和无病生存率无明显相关.结论 咽后淋巴结转移与N分期和临床分期相关,主要是同侧转移,交叉转移比例低.咽后淋巴结阳性和鼻咽癌局部复发率、远处转移率及生存率明显相关.咽后淋巴结坏死与鼻咽癌调强放疗后局部复发率、远处转移率明显相关,与总生存率、无病生存率相关性不明确,需进一步随访观察.
目的 探討鼻嚥癌嚥後淋巴結暘性率和壞死率與臨床療效的關繫,為製定綜閤治療方案提供參攷.方法 選取2004年8月至2007年3月接受調彊放療的72例鼻嚥癌患者,在CT定位圖像上勾畫嚥後淋巴結及壞死區,計算壞死區體積,分析嚥後淋巴結暘性率及壞死率與臨床相關因素的關繫.結果 頸部淋巴結轉移率為90.3％,其中,I區轉移率為2.8％,Ⅱ區為86.0％,Ⅲ區為51.4％,Ⅳ區為20.8％,Ⅴ區為37.5％.嚥後淋巴結轉移率為79.2％,嚥後淋巴結交扠轉移率為6.9％.嚥後淋巴結暘性者中,左側齣現壞死佔21.6％,右側齣現壞死佔27.2％,雙側均齣現壞死佔15.4％.嚥後淋巴結轉移與N分期和臨床分期有明顯相關性(福州92分期,r =0.383、-0.314,P＜0.05;UICC分期,r=-0.434、-0.306,P ＜0.05).中位隨訪時間36箇月,4例齣現複髮,6例齣現遠處轉移,死亡7例.嚥後淋巴結暘性與複髮率、遠處轉移率及生存率、無病生存率明顯相關(r=0.085、0.138、-0.140、-0.124,P＜0.05);嚥後淋巴結壞死與複髮率、遠處轉移率相關(r=0.256、-0.057,P＜0.05),與生存率和無病生存率無明顯相關.結論 嚥後淋巴結轉移與N分期和臨床分期相關,主要是同側轉移,交扠轉移比例低.嚥後淋巴結暘性和鼻嚥癌跼部複髮率、遠處轉移率及生存率明顯相關.嚥後淋巴結壞死與鼻嚥癌調彊放療後跼部複髮率、遠處轉移率明顯相關,與總生存率、無病生存率相關性不明確,需進一步隨訪觀察.
목적 탐토비인암인후림파결양성솔화배사솔여림상료효적관계,위제정종합치료방안제공삼고.방법 선취2004년8월지2007년3월접수조강방료적72례비인암환자,재CT정위도상상구화인후림파결급배사구,계산배사구체적,분석인후림파결양성솔급배사솔여림상상관인소적관계.결과 경부림파결전이솔위90.3％,기중,I구전이솔위2.8％,Ⅱ구위86.0％,Ⅲ구위51.4％,Ⅳ구위20.8％,Ⅴ구위37.5％.인후림파결전이솔위79.2％,인후림파결교차전이솔위6.9％.인후림파결양성자중,좌측출현배사점21.6％,우측출현배사점27.2％,쌍측균출현배사점15.4％.인후림파결전이여N분기화림상분기유명현상관성(복주92분기,r =0.383、-0.314,P＜0.05;UICC분기,r=-0.434、-0.306,P ＜0.05).중위수방시간36개월,4례출현복발,6례출현원처전이,사망7례.인후림파결양성여복발솔、원처전이솔급생존솔、무병생존솔명현상관(r=0.085、0.138、-0.140、-0.124,P＜0.05);인후림파결배사여복발솔、원처전이솔상관(r=0.256、-0.057,P＜0.05),여생존솔화무병생존솔무명현상관.결론 인후림파결전이여N분기화림상분기상관,주요시동측전이,교차전이비례저.인후림파결양성화비인암국부복발솔、원처전이솔급생존솔명현상관.인후림파결배사여비인암조강방료후국부복발솔、원처전이솔명현상관,여총생존솔、무병생존솔상관성불명학,수진일보수방관찰.
Objective To investigate the correlation of the the positive rate and necrosis rate of retropharyngeal lymph nodes with the clinical effects of intensity modulated radiotherapy (IMRT) in treatment of nasopharyngeal carcinoma (PNC).Methods Seventy-two patients with PNC,50 males and 22 females,with the median age of 50,underwent IMRT delivered into 33 times.The retropharyngeal lymph nodes involved and positive lymph nodes of neck were delineated on the CT image.The median dose and median fractionated dose for gross tumor volume (GTV) were 70.0 and 2.12 Gy respectively,and the median dose and median fractionated dose for clinical target volume (CTV) were 70.0 and 2.12 Gy respectively.The patients were followed up for 36 (5-54) months.Results The metastasis rate of the neck lymph nodes was 90.3％,the metastasis rates in the regions Ⅰ-Ⅴ were 2.8％,86.0％,51.4％,20.8％,and 37.5％,respectively.The metastasis rate of the retropharyngeal lymph nodes was 79.2％,and specifically the metastasis rates of the left,right,and bilateral retropharyngeal lymph nodes were 51.4％,45.9％,and 18.1％,respectively.The cross metastasis rate was 6.9％.Necrosis of the retropharyngeal lymph nodes was found in 15 cases.The necrosis rates of the left,right,and bilateral retropharyngeal lymph nodes were 21.6％,27.2％,15.4％,respectively.Retropharyngeal lymph nodes metastasis was significantly correlated with N stage and clinical stage(Fuzhou 92:r =-0.383,-0.314,P ＜ 0.05 ; UICC:r =-0.434,-0.306,P ＜ 0.05).Local recurrence was observed in 4 patients,6 patients had distant metastasis,and 7 patients died.The positiveness of retropharyngeal lymph nodes was significantly correlated with the recurrence rate,distant metastasis rate,survival rate,and disease free survival rate (r =0.085,0.138,-0.140,-0.124,P ＜ 0.05),and the necrosis of the retropharyngeal lymph nodes was significantly correlated with the recurrence rate and distant metastasis rate (r =0.256,-0.057,P ＜ 0.05),and not significantly correlated with the survival rate and disease free survival rate.Conclusions Retropharyngeal lymph nodes metastasis in NPC is correlated with the N stage and clinical stage.The positiveness of retropharyngeal lymph nodes is significantly correlated with local recurrence,distant metastasis,and survival.Necrosis of retropharyngeal lymph nodes in NPC is significantly correlated with local recurrence and distant metastasis after IMRT.
