摘要
目的探讨调强适形放疗对腮腺功能的保护作用。方法采用随机均衡设计方法将80例鼻咽癌患者分为调强适形放疗组(治疗组)和常规放疗组(对照组),每组40例。治疗组pGTVnx 72.0 Gy,对照组放疗2.0 Gy/次,5次/周,总量70.0 Gy。于放疗前、放疗结束时及放疗后3个月、6个月、1年及2年进行腮腺动态显像检测,计算腮腺的放射性摄取指数(UI)及酸性刺激后的分泌指数(EI)。并利用DVH图对腮腺组织进行受量分析。结果治疗组患者放疗结束时腮腺的UI和EI分别下降22.9%和32.2%;对照组放疗结束时UI和EI分别下降56.6%和80.6%;放疗后2年治疗组患者腮腺UI和EI恢复到原来的97.2%和95.2%,对照组放疗后发生永久性的腮腺功能损伤,摄取指数下降92.0%,基本丧失分泌功能。治疗组患者的健侧腮腺受照射的平均剂量为20.5 Gy,患侧平均剂量为32.5 Gy,对照组健侧腮腺受照射平均剂量为61.6 Gy,患侧平均剂量为68.7 Gy。结论调强适形放疗可以明显减少腮腺所受的照射剂量,有效保护腮腺功能。
Objective To study the protection of parotid function by intensity modulated radiation therapy. Methods 80 nasopharyngeal carcinoma （NPC） patients were divided into intensity modulated radiation therapy group （IMRT group） and conventional fraction group （control group or CF group） by random balanced design. The IMRT group received a total dosage of 72. 0 Gy to Planning Gross Tumor Volume of nasopharynx. The control group was given a total dosage of 70.0 Gy with daily fraction of 2. 0 Gy and five times a week. Parotid imagings were performed in all patients before radiation and 3 months, 6 months, 9 months, 1 year, and 2 years after treatment. Both uptake index （UI） and excretion index （EI） were calculated. The received dosage by the parotid was analyzed by dose-volume histogram （DVH）. Results UI and EI of the IMRT group at the end of therapy declined by 22. 9% and 32. 3% respectively , while those of the control group declined by 56. 6% and 80. 6%. 2 years after treatment, UI and EI of the IMRT group recovered to 97. 2% and 95. 2%, while the UI of the control group declined to 92. 0%, which meant permanent loss of the parotid function. Conclusion IMRT can spare more parotid gland than CF and thus protect parotid function effectively.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2007年第2期118-122,共5页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
关键词
鼻咽肿瘤
放射疗法
分泌腺功能
Nasopharyngeal neoplasm
Radiation therapy
Secreting gland function
