初治鼻咽癌调强适形放疗近期临床观察
The Short-term Clinical Observation of IMRT in First-treated Nasopharyngeal Carcinoma
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摘要: 目的研究调强放射治疗(IMRT)对初治鼻咽癌的疗效以及对正常组织的保护和毒性反应。方法对24例鼻咽癌初治患者鼻咽和全颈及锁骨上全程实施IMRT,肿瘤靶区授予处方剂量68~70Gy。对于Ⅲ和Ⅳ期患者,在IMRT同时,结合患者淋巴结转移及一般情况给予PDD+5-Fu±THP-ADM方案化疗1~2周期。结果治疗计划结果显示,覆盖鼻咽GTV1D95的平均剂量为70.48Gy,GTV1V95的平均体积为98.46%;靶区内GTV1、GTV2、CTV1和CTV2的平均剂量分别为70.48Gy、66.98Gy、60.10Gy和51.18Gy。本组有2例、16例、5例和1例患者分别出现0、1、2和3级的皮肤急性放射性反应;有4例、6例、13例和1例患者分别出现1、2、3和4级的口腔粘膜急性放射性反应;其中1例合并联合化疗患者因严重口腔粘膜炎中断放疗1周。其他合并化疗患者在化疗后均出现不同程度的骨髓抑制,经对症处理均未影响正常放射治疗。本组患者中位随访期13个月。无1例出现局部复发或远处转移。结论IMRT在初治早期或晚期鼻咽癌病例均可获得理想的剂量分布,正常组织得到很好的保护,毒副反应可以耐受,临床疗效令人满意。Abstract: Objective To evaluate the feasibility, toxicity and clinical efficacy of intensity modulated radiation therapy (IMRT) for first-treated nasopharyngeal carcinoma. Methods Twenty-four patients of first-treated nasopharyngeal carcinoma were treated with full course IMRT including nasopharynx and full neck to supraclavicle. The radiotherapy dosage is 68-70Gy to the target. Of these patients, those who were classified as clinical stage Ⅲ or Ⅳ received 1 or 2 courses concurrent chemotherapy, and the chemotherapy ...
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