鼻咽癌放射治疗后脑损伤49例临床分析

目的:分析鼻咽癌放射性脑损伤的临床特点及预后因素.方法:回顾性分析1998年1月至2006年6月我院收治的49例鼻咽癌放射性脑损伤患者的临床资料.结果:鼻咽癌单程放疗及再程放疗放射性脑损伤的发生率分别为2.31%(30/1 298),9.64%(19/197)(P＜0.05).单程放疗及再程放疗放射性脑损伤的中位潜伏期分别为50.5个月与25.5个月(P＜0.05).颞叶型、脑干型及混合型放射性脑损伤所占的比例分别为75.5%(37/49)、18.4%(9/49)、6.1%(3/49).经积极对症治疗后,放射性脑损伤的症状及体征有所改善,但生活质量明显下降.结论:鼻咽癌放射性脑损伤与射野的设计相关.放射性脑损伤以颞叶型发生率较高,再程放疗放射性脑损伤的发病率最高,且潜伏期明显缩短.

Radiation Injury in the Brain after Radiotherapy for Nasopharyngeal Carcinoma

Objective:To study the clinical features and prognostic factors of brain injury after radiothera-py for nasopharyngeal carcinoma(NPC).Methods:From January 1998 to June 2006,49 NPC patients with Dost-radiation brain injury in our hospital were analyzed retrospectively.Results:The incidence of post-radia-tion brain injury after single-pass radiotherapy and re-course radiotherapy was 2.31%and 9.64%.respectively ,(P＜0.05).The median latency period was 50.5 months for single-pass radiotherapy and 25.5 months for re-course radiotherapy.Fourty-nine patients suffered from radiation injury in the brain.The lesions were locat-ed in the temporal lobe in 37 patients(75.5%),in the pens in 9 patients(18.4%)and in mixed position in 3 pa-tients(6.1%).The symptoms and signs of the patients could be alleviated by therapy, but the quality of life was not improved.Conclusion:Radiation brain injury in NPC patients after radiotherapy is related to field de-sign.The incidence of radiation brain injury in the temporal lobe is the highest.Compared with single-pass ra-diotherapy, re-course radiotherapy leads to higher incidence of brain injury and shorter latency period.