鼻咽癌调强放疗与三维适形放疗疗效及不良反应分析

摘要/Abstract

摘要： 目的探究调强适形放疗方案与三维适形放疗方案对鼻咽癌疗效及安全性的影响。方法回顾性选取2018年3月—2022年3月于邹平市中医院确诊及接受治疗的80例局部晚期鼻咽癌（NPC）患者作为研究对象,其中37例接受调强适形放疗方案治疗（IMRT）（治疗组）,另43例接受三维适形放疗方案治疗（3D-CRT）（对照组）,观察两组近期疗效、危及器官最大/平均剂量及不良反应发生情况。结果治疗组总短期治疗有效率与对照组比较,差异无统计学意义（P>0.05）;两组危及器官中视神经及视交叉神经最大/平均剂量比较,差异无统计学意义（P>0.05）;治疗组危及器官中耳内（左、右）、脑干、脊髓最大/平均剂量低于对照组,差异有统计学意义（P<0.05）。治疗组放疗开始后4周出现放射性黏膜炎及放射性皮炎等急性不良反应发生率低于对照组,差异有统计学意义（P<0.05）;治疗组放疗结束半年后出现放射性涎腺损伤发生率低于对照组,差异有统计学意义（P<0.05）。放疗结束后半年两组患者放射性脑损伤发生率比较,差异无统计学意义（P>0.05）。结论 IMRT和3D-CRT在治疗局部晚期NPC具有相似的疗效,但IMRT在照射剂量及减少放射性损伤的不良反应中均存在较高优势。

关键词: 鼻咽癌, 强适形放疗, 三维适形放疗, 不良反应, 疗效

Abstract: Objective To explore the effects of intensity modulated conformal radiotherapy(IMRT) and three-dimensional conformal radiotherapy(3DCRT) on the efficacy and safety of nasopharyngeal carcinoma(NPC). Methods A total of 80 patients with locally advanced nasopharyngeal carcinoma who were diagnosed and treated in the Traditional Chinese Medicine Hospital of Zouping City from March 2018 to March 2022 were retrospectively selected, including 37 patients receiving intensity modulated conformal radiotherapy(IMCR)(treatment group) and 43 patients receiving three-dimensional conformal radiotherapy(3D-CRT)(control group). The short-term efficacy, maximum/average organ threatening dose,and adverse reactions of the two groups were observed. Results There was no difference in the total short-term treatment response rate between the treatment group (97.30%) and the control group (93.02%) (P>0.05); There was no difference in the maximum/average doses of the optic nerve and the chiasmatic nerve in the organs at risk between the two groups (P>0.05); The maximum/average dose of organs in the middle ear (left and right), brain stem, and spinal cord in the treatment group was lower than that in the control group (P<0.05); The incidence of acute adverse reactions such as radiation mucositis (45.95%) and radiation dermatitis (35.14%) in the treatment group was significantly lower than that in the control group (P<0.05); The incidence of radiation induced salivary gland injury in the treatment group (29.73%) was lower than that in the control group (76.74%) six months after radiotherapy (P<0.05). There was no difference in the incidence of radiation brain injury between the two groups (P>0.05). Conclusion IMRT and 3D-CRT have similar efficacy in the treatment of locally advanced NPC, but IMRT has higher advantages in both radiation dose and reducing adverse reactions caused by radiation damage.

Key words: nasopharyngeal carcinoma, intensive modulated conformal radiotherapy, three dimensional conformal radiotherapy, adverse reactions, curative effect

中图分类号:

R739.62

王保明. 鼻咽癌调强放疗与三维适形放疗疗效及不良反应分析[J]. 中华养生保健, 2024, 42(11): 194-197.

WANG Bao-Ming. Analysis of Efficacy and Adverse Reactions of Intensity Modulated Radiotherapy and Three-dimensional Conformal Radiotherapy for Nasopharyngeal Carcinoma[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(11): 194-197.

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