| 鼻咽癌调强放疗患者腮腺功能的动态观察 |
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| 引用本文： | 何霞云,章英剑,应红梅,胡超苏,何少琴. 鼻咽癌调强放疗患者腮腺功能的动态观察[J]. 复旦学报(医学版), 2009, 36(3): 288-291. DOI: |
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| 作者姓名： | 何霞云 章英剑 应红梅 胡超苏 何少琴 |
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| 作者单位： | 复旦大学附属肿瘤医院放疗科-复旦大学上海医学院肿瘤学系;复旦大学附属肿瘤医院核医学科-复旦大学上海医学院肿瘤学系,上海,200032 |
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| 摘 要： | 目的 观察调强放射治疗鼻咽癌患者腮腺功能的动态变化.方法 33例鼻咽低分化鳞癌患者,其中Ⅰ期1例、Ⅱ期4例、Ⅲ期14例、Ⅳa期14例(92分期),Ⅰ、Ⅱ期行单纯放疗,Ⅲ、Ⅳ期采用放化疗.全部患者接受调强放射治疗,PTVg 66 Gy/30 F,鼻咽和上颈部、下颈部PTVc分别是60 Gy/30 F、54 Gy/30 F.在放疗前、放疗中、放疗结束、随访时行放射性核素显像以检测腮腺99mTc清除率测定其摄取指数(UI)、分泌指数(EI),并结合腮腺的剂量体积直方图(DVH)和患者口干症状进行分析.结果 腮腺EI值放疗前为0.58±0.13,放疗中为0.17±0.22,放疗结束时为0.09±0.17,随访中为0.42±0.18,放疗中和放疗结束时均比放疗前有下降,随访时比放疗结束时有上升,差异有显著统计学意义(P=0.000).随访时间<6月、≥6月的EI值分别时0.30±0.21,0.53±0.12,差异有显著统计学意义(P=0.002).其UI值在4个时间点分别为5.05±2.28、5.78±2.41、5.38±2.10、4.52±2.25,差异无显著统计学意义(P=0.070).DVH结果:全组腮腺平均剂量35.5 Gy,V26平均值为71.3%.腮腺平均剂量≤median和腮腺平均剂量>median的EI值在随访中分别为0.505±0.103、0.373±0.136(P=0.007).V26≤median、V26>median的EI值在随访中分别为0.490±0.120、0.403±0.136(P=0.086).两种情况UI差异均无统计学意义(P>0.05).根据肿瘤放射治疗协作组标准:放疗结束时口干Ⅰ度5例(15%)、Ⅱ度28例(85%),随访中:0度6例(18%)、Ⅰ度23例(70%)、Ⅱ度4例(12%).平均随访时间为17月(10～22月),1例原发灶、上颈部淋巴结同时复发,3例远处转移,其中1例死亡.结论 调强放疗对腮腺功能的影响表现在EI,腮腺放射剂量低,有利于腮腺功能的保护,放疗后腮腺功能随时间的延长而逐步恢复.
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| 关 键 词： | 鼻咽肿瘤 腮腺功能 调强放疗 放射性核素显像 |
| 收稿时间： | 2008-11-18 |
Relationship between the parotid glands function and the dose-volume effect in nasopharyngeal carcinoma patients with intensity-modulated radiotherapy by radionuclide imaging |
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| HE Xia-yun,ZHAN Ying-jian,YING Hong-mei,HU Chao-su,HE Shao-qin. Relationship between the parotid glands function and the dose-volume effect in nasopharyngeal carcinoma patients with intensity-modulated radiotherapy by radionuclide imaging[J]. Fudan University Journal of Medical Sciences, 2009, 36(3): 288-291. DOI: |
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| Authors: | HE Xia-yun ZHAN Ying-jian YING Hong-mei HU Chao-su HE Shao-qin |
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| Affiliation: | 1Department of Radiation Oncology;Cancer Hospital-Department of Oncology;Shanghai Medical College;Fudan University;Shanghai 200032;China;2Department of Nuclear Medicine;China |
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| Abstract: | Objective To evaluate the parotid glands function and the dose-volume effect in nasopharyngeal carcinoma (NPC) patients with intensity-modulated radiation therapy (IMRT) by radionuclide imaging. Methods From July 2005 to July 2006,the excretion index (EI) and uptake index (UI)of parotids in 33 NPC patients with radical IMRT was examined by radionuclide imaging,prior to IMRT,and at median dose,at the end of radiotherapy,and the follow-up time after radiotherapy. The relationship between parotid function (EI ... |
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| Keywords: | nasopharyngeal neoplasm parotid gland function intensity-modulated radiotherapy radionuclide imaging |
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