常规摆位面颈联合大野治疗鼻咽癌颅神经放射损伤的临床分析

目的探讨常规摆位面颈联合大野治疗鼻咽癌颅神经放射损伤发生的原因,以寻找其预防措施.方法回顾性分析1993年6月～1997年9月首程放疗并采用面颈联合野治疗的鼻咽癌376例.采用直接统计法分析颅神经放射损伤发生相关因素.结果颅神经损伤发生率为16.5%(62/376),以后组颅神经放射损伤为最常见.中位数潜伏期为5年.结论颅神经放射损伤的发生与颈部剂量分布不均导致的颈动脉鞘区结缔组织放射性纤维变密切相关,适形放射治疗有可能降低颅神经放射损伤的发生.

Clinical analysis of radiation induced cranial neuropathy after radiotherapy of nasopharyngeal carcinoma with traditional facio-cervical portal

Objective To evaluate the cause of radiation induced cranial neuropathy(RICN)after radiotherapy of nasopharyngeal carcinoma(NPC) with traditional facio cervical portal Methods The clinical data of 376 patients undergone radiotherapy of nasopharyngeal carcinoma with traditonal facio cervical portal were analyzed retrospectively Results The incidence of RICN after treatment,was 16 5%(62/376),and the posterior cranial nerves were most often affected The median latency of RICN was 5 years And the relative factors of RICN were analyzed statistically Conclusion While the anterior upper neck tangential portal is combized with the facio cervical portal,the overlap of the two fields combination in the submandibular angle area might cause the overdosage in the carotid sheath space which may induce the radiation fibrosis of the connective tissues,and the radiation induced cranial neuropathy is closely related to the radiotion fibrosis in the carotid sheath space The comformal radiotherapy may decrease RICN rate