摘要
背景与目的:鼻咽癌放疗后视神经的损伤越来越受到重视,适形调强放疗(IMRT)作为一种精确放疗技术,对视神经保护具有一定的优势,但缺乏相关临床数据。本研究通过对鼻咽癌患者放疗计划剂量和临床结果分析,了解IMRT对视神经保护的作用。方法:9例初治鼻咽癌男性患者于2007年12月至2008年12月接受了适形调强放疗,其中T2 3例,T3 6例。由IMRT计划系统得到视神经受照剂量及视神经与鼻咽肿瘤的距离,并于放疗前和放疗后6个月检测患者双侧视神经的视力、视野和视诱发电位。结果:9例患者均无视神经功能损伤的表现,视神经剂量受肿瘤生长的部位影响,视神经与肿瘤的最短距离和视神经最大剂量呈显著负相关(r=-0.912,P<0.001)。结论:IMRT技术可以较好地保护鼻咽癌患者的视神经功能,视神经与肿瘤的最短距离是视神经剂量的决定因素。
BACKGROUND OBJECTIVE： More and more attentions are paid to the optic nerve damage in nasopharyngeal carcinoma（NPC） patients after radiotherapy.As an precise irradiation technology,intensity-modulated radiotherapy（IMRT） has certain advantages to protect the optic nerve,but there is relative lack of clinical data.In this study,we investigated the radiotherapy planned dose and clinical results of nasopharyngeal carcinoma patients.We explored the value of IMRT in optic nerve protection.METHODS： Nine male patients with primary nasopharyngeal carcinoma received IMRT between Dec.2007 and Dec.2008.According to 2002 UICC/AJCC staging system,3 patients were staged as T2 and 6 as T3.The delivered dose to optic nerves and the shortest distance from optic nerve to tumor were calculated with IMRT planning system.The eyesight,visual field and visual evoked potential（VEP）were detected before IMRT and six months after IMRT.RESULTS：All patients are alive by the end of June 2011,and there were no radiation optic neuropathy（RON）.The dose delivered to optic nerves is influenced by the tumor locations.The maximal doses of optic nerves is significantly correlated with the shortest distance from nerve to tumor（r=0.912,P0.001）.CONCLUSONS：IMRT techniques could preferably protect the optic nerve function in NPC patients.The shortest distance from nerve to tumor is a determining factor to the received dose of the optic nerves.
出处
《中国神经肿瘤杂志》
2011年第3期171-175,共5页
Chinese Journal of Neuro-Oncology
基金
广东省医学科学基金项目资助(NoA20080219)
