You Position: Home > Paper
Intensify modulated radiotherapy (IMRT) for nasopharyngeal carcinoma
( views:296, downloads:33 )
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIATION ONCOLOGY
- Issue:
- 3
- DOI:
- 10.3760/j.issn:1004-4221.2004.03.003
- Key Word:
- 鼻咽肿瘤/放射疗法;调强放射治疗;预后
Abstract： 目的研究同步加量调强放射治疗(SMART)对鼻咽癌的疗效以及对正常组织的保护和毒性反应.方法对38例鼻咽癌初治患者大体肿瘤和肿大淋巴结给予SMART,2.5 Gy/次,共28次,总量加70Gy.亚临床灶和预防照射区接受常规照射,2.0 Gy/次,共28次,总量56Gy.均照射1次/d,5次/周,总治疗时间为38 d.腮腺功能测定采用99mTc核素显像法,采用摄取指数(UI)和分泌指数(EI)验证SMART对腮腺功能的保护作用.结果治疗计划结果显示临床靶体积(CTV)的D95为53.8 Gy,平均剂量57.0Gy,95%等剂量线(54Gy)可以覆盖98%的CTV.大体肿瘤体积(GTV)的D95为64.5Gy,平均剂量67.2Gy,90%等剂量线(63Gy)覆盖98%～99%的GTV.健侧腮腺的平均剂量为23Gy,实际腮腺功能测定显示健侧腮腺功能变化在治疗前后无明显改变;患侧腮腺的UI、EI疗后比疗前分别下降43.6%和26.3%(P＜0.05).全组患者黏膜和咽部反应较重,但未发生严重的4级不良反应.治疗结束3个月后,完全缓解率为89.5%(34/38),有效率为100%(38/38),1年生存率为100%.结论SMART技术无论在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.
- [1]胡超苏,环素兰,张有望.鼻咽癌超分割合并缩野加量放射的前瞻性随机研究[J].1998,(2).
- [2]Lee N,Poon I,Akazawa P,etc.Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience.[J].2002,53(1).
- [3]Chiu JK,Grant WH-3rd,Uhl BM,etc.Smart (simultaneous modulated accelerated radiation therapy) boost: a new accelerated fractionation schedule for the treatment of head and neck cancer with intensity modulated radiotherapy.[J].1999,45(1).
- [4]Mohan R,Schmidt Ullrich-R,Wu Q,etc.Radiobiological considerations in the design of fractionation strategies for intensity-modulated radiation therapy of head and neck cancers.[J].2000,46(3).
- [5]Ozyigit G,Dempsey JF,Chao KS,etc.Patterns of failure in patients receiving definitive and postoperative IMRT for head-and-neck cancer.[J].2003,55(2).