CT模拟与三维计划对减低鼻咽癌放疗并发症的价值

目的了解引起鼻咽癌放射治疗并发症的影响因素,通过观察CT模拟及三维计划与X线模拟二维计划比较分析对鼻咽癌放射并发症的影响.方法临床观察从1995年～2005收治的并且能够随诊到的161例鼻咽癌病人放疗后出现的并发症.临床从张口受限、急性皮肤反应、颈部组织纤维化、口干症以及鼻腔粘连等并发症来观察结果.结果颈部组织纤维化中、重度,三维计划分别为8/108(7.4%)和1/108(0.9%);二维计划分别为8/53(15.1%)和4/53(7.5%).口干症中、重度三维计划分别为10/108(9.3%)和3/108(2.8%);二维计划分别为17/53(32.1%)和9/53(17.0%).急性皮肤反应中、重度三维计划分别为18/108(16.7%)和8/108(7.4%);二维计划分别为19/53(35.8%)和11/53(20.8%).张口受限三维计划为7/108(6.5%);二维计划为12/53(22.6%).鼻腔粘连三维计划为12/108(11.1%),二维计划为13/53(24.5%).结论CT模拟与三维计划可明显降低放疗并发症的发生.

Value of CT-simulation and 3-DRTP to reduce radiotherapy complication on NPC

[Objective] To observe the effective factors of complication on radiation therapy of NPC(nasopharyngeal carcinoma)and to observe the effect of CT-simulation and 3-DRTP(three-dimensional radiation therapy treatment planning)to X-simulation and two-dimensional radiation therapy treatment planning.[Methods] To look into the radiotherapy complication of the 161 patients with NPC who can be measured at any time from 1995 to 2005.To observe the result from the limitation of gape,the urgent skin's reaction,the cervix organizing fibrosis,xerostomia,conglutination of the nasal cavity and so on.[Results] The intermedia and severe complication of the cervix organizing fibrosis 3-DRTP distinguish to 8/108(7.4%)and 1/108(0.9%),2-DRTP distinguish to 8/53(15.1%)and 4/53(7.5%).The intermedia and severe complication of xerostomia 3-DRTP distinguish to 10/108(9.3%)and 3/108(2.8%),2-DRTP distinguish to 17/53(32.1%)and 9/53(17.0%).The intermedia and severe complication of the urgent skin's reaction 3-DRTP distinguish to 18/108(16.7%)and 8/108(7.4%),2-DRTP distinguish to 19/53(35.8%)and 11/53(20.8%).The limitation of gape 3-DRTP is:7/108(6.5%),2-DRTP is 12/53(22.6%).The conglutination of the nasal cavity 3-DRTP is 12/108(11.1%),2-DRTP is 13/53(24.5%).[Conclusion] CT-simulation and 3-DRTP radiotherapy can reduce the radiotherapy complication.