摘要
背景与目的:鼻咽癌是头颈部常见的恶性肿瘤,由于鼻咽部及周边解剖结构复杂,根治性切除术无法进行,放射治疗是主要的治疗手段。近年来,三维适形放疗开展日趋增多,本研究应用半野单中心面颈野三维适形放疗技术治疗鼻咽癌。方法:2004年1月—2006年6月,来我院就诊的40例病理证实鼻咽癌患者,均行CT定位,依据CT图像、MRI图像和融合图像确定相应靶区及危险器官,用3D-TPS制定计划,采用半野单中心面颈野三维适形放疗技术治疗患者,应用Kaplan-Meier方法计算生存率、局部控制率和无瘤生存率;并用RTOG标准判定放疗急性反应。结果:使用CT和MRI融合技术作为靶区确定的依据,从而提高了靶区勾画的准确性,鼻咽区平均剂量为69.8～71.2Gy/34次。中位随访时间16个月,1年及2年总生存率均为95%,1年及2年局部控制率分别为92.5%和90%,1年及2年无瘤生存率分别为90%和85%。皮肤、黏膜急性反应均以Ⅰ级和Ⅱ级为主。结论:应用CT和MRI融合技术勾画鼻咽癌靶区,半野单中心面颈野三维适形放疗技术,肿瘤区的照射剂量高且分布均匀并保护了危险器官,适于在非肿瘤专科医院的放疗中心推广。
Background and purpose： Nasopharyngeal carcinoma is a common malignant neoplasm of the head and neck region. Because of the deep-seated site of the nasopharynx and the anatomical proximity to critical structures, radical surgical resection is very difficult. Radiation therapy has always been the main treatment. Three-dimensional conformal radiation therapy has been developed rapidly. We studied mono-isocentric semiportal technique of facio-upper neck field with three-dimensional conformal radiation therapy for nasopharyngeal carcinoma. Methods： From January 2004 to June 2006, 40 patients with nasopharyngeal carcinoma were enrolled. CT simulation and MRI scans were obtained for 40 NPC patients. Using CT and fused CT/MRI, various target volumes and critical organ at risk were outlined. Three-dimensional conformal radiation therapy planning was accomplished by CMS（FOCUS3.23）. The loco-regional control rate, disease free survival rate and overall survival rate were estimated using the Kaplan-Meier method. The acute normal tissue effects were graded according to the Radiation Therapy Oncology Group（RTOG） radiation morbidity scoring criteria. Results： Using CT and fused CT/MRI, various target volumes and critical organ at risk could be more accurately contoured. The mean dose of nasopharyngeal region was 69.8-71.2 Gy/34 fractions. The 1-, 2-year overall survival rates were 95% and 95%, and loco-regional control rates were 92.5% and 90%. The disease free survival rates were 92.5% and 90%. The acute toxicity was mostly grade Ⅰ- Ⅱ. Conclusions： The mono-isocentric semiportal technique of facio-upper neck field with 3-dimensional conformal radiation therapy for nasopharyngeal carcinoma may enhance the dose to target region and improve the nearby critical normal structures protection.
出处
《中国癌症杂志》
CAS
CSCD
2007年第8期610-614,共5页
China Oncology
关键词
鼻咽癌
三维适形放疗
半野单中心面颈野放疗技术
nasopharyngeal carcinoma
3-dimensional conformal radiation therapy
mono-isocentric semiportal technique of facio-upper neck field
