摘要
目的:探讨面罩固定整体挡铅技术在鼻咽癌治疗中的应用。方法:利用鼻咽+颈部CT/MR,采用面罩固定同中心照射,模拟定位摄取颈部X线照片,根据鼻咽癌病灶侵犯的范围勾画照射靶区,制作低熔点挡铅,并在治疗机或模拟机上验证挡块。将2005～2006年收治的124例鼻咽癌患者随机分为利用整体挡铅治疗组与调强治疗组进行放射治疗,比较1、3年生存率。结果:1)第一步计划常规面颈联合野及下颈部切线野。第二步计划面颈分野+颈部切线野,侵及口咽时,采用小面颈联合野,后界前移到颈椎椎体前缘,避开脊髓,其颈部后三角区采用电子束补偿照射。2)根据鼻咽CT/MR侵及范围相应扩大局部照射野。整体挡铅治疗的患者1、3年生存率与调强放疗组无明显差异(P>0.05)。结论:1)面罩固定同中心整体挡铅技术可根据鼻咽癌侵及范围勾画个体化照射野计划。2)通过精确适形设野,使鼻咽、口咽、颅底、颈部包括在一个照射野内,靶区设计更合理,剂量分布更均匀,并能有效遮挡附近重要器官。
Objective： To evaluate the application of mask fixation and integrated block in radiotherapy for nasopharyngeal carcinoma. Methods： The delineation of portal boundaries was based on nasopharynx and upper neck CT/MRI scan in all patients. Patients took facio-cervical X-ray radiograph on simulator. The portal volume boundaries were delineated on the radiograph according to the range of involvement of the tumor. And the portal volume boundaries were checked by therapeutic machine or analog machine. A total of 124 patients were collected between 2005 and 2006 and were randomly divided into two groups. Group A received treatment with integrated block and Group B received intensity modulated radiotherapy. The 1- and 3-year overall survival rates were analyzed. Results： ①The posterior boundary of the portals were shifted to the posterior margin of the cervical vertebrae body and the posterior cervical triangular regions were irradiated with electric beam. ②On the basis of a general rule of facio-cervical portals, the portals were correspond- ingly extended according to CT/MRI scan showing the ranges of tumor involvement. ③The 1- and 3-year overall survival rates in the two groups were not significantly different （P〉0.05）. Conclusion： ①lntegrated block and mask fixation can help identify individualized radiation field according to the ranges of tumor involvement. ② Through accurately designed conformal portals, nasopharynx, oropharynx, base of skull and cervical part could be included in one exposure field. The irradiation target volume would be designed more rationally, and the nearby important organs can be shielded effectively.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2009年第18期1024-1026,共3页
Chinese Journal of Clinical Oncology
基金
南通市卫生局基金项目资助(编号:W0513)
关键词
鼻咽癌
放射治疗
面颈联合野
CT/MR扫描
铅档块遮挡
Nasopharyngeal carcinoma
Radiotherapy
Facio-cervical portals
CT/MRI scan
Block shielding
