三维适形放疗与适形调强放疗对T3～4期鼻咽癌的疗效及对耳部的影响

目的]观察不同放射治疗方案对T3～4期鼻咽癌患者耳部的影响.方法]回顾性分析本院就诊的102例T3～4期鼻咽癌患者的临床资料,适形调强放疗（IMRT）组56例,三维适形放疗（3D-CRT）组46例,比较两组疗效、放射性中耳炎发生率及听力受损情况.结果]两组患者近期局部控制率差异无统计学意义（P＞0.05）,3D-CRT组的中耳及耳蜗照射剂量明显高于IMRT组（P＜0.05）,两组放疗后6个月中耳炎发生率及听力损伤发生率比较,差异无统计学意义（P＞0.05）.结论]对T3～4期鼻咽癌患者放疗后耳功能的保护,IMRT比3D-CRT技术具有剂量学优势,但未见临床优势,3D-CRT对经济条件较差的患者仍是性价比较高的选择.

Study of the Impact of Different Radiation Therapy Methods on Ears of Patients with T3 and T4 Stage Nasopharyngeal Carcinoma

Objective]To observe the impact of different radiation therapy methods on ears of patients with T3 and T4 stage nasopharyngeal carcinoma.Methods] Clinical data of 102 patients with T3 and T4 stage nasopharyngeal carcinoma in our hospital were analyzed retrospectively.All patients were divided into intensity-modulated radiation therapy （IMRT） group （n =56） and 3-dimensional conformal radiation therapy （3D-CRT） group（n =46）.The efficacy,the incidence of radioactive otitis media and hearing impairment were compared between two groups.Results]There was no significant difference in short-term local tumor control rate between two groups（P ＞0.05）.Exposure dose of middle ear and cochlea in 3D-CRT group was significantly higher than that in IMRT group（P ＜0.05）.There was no significant difference in the incidence of otitis media and hearing impairment between two groups at 6 months after radiotherapy（P ＞0.05）.Conclusion] For the protection of ear function in patients with T3 and T4 stage nasopharyngeal carcinoma after radiotherapy,IMRT is superior to 3D-CRT in the aspect of dosage,but not in clinical efficacy.The 3D-CRT is still a top priority for patients with poor economic condition.