摘要
背景与目的:自上世纪90年代,中山大学肿瘤医院鼻咽癌常规外照射采用面颈联合野、耳前野和低熔点挡铅技术,本研究通过分析部分常规放疗后局部区域复发患者的资料探讨常规鼻咽癌面颈联合野和耳前野照射范围的合理性。方法:收集1999年在中山大学肿瘤医院按常规面颈联合野和耳前野设野治疗的,放疗后局部区域出现复发,有放疗前后和复发CT检查的鼻咽癌患者资料,分析复发灶所侵犯的部位。对于有照射野设置资料患者,在三维治疗计划系统(3DTPS)下进一步行局部复发灶和照射野模拟剂量学分析,观察复发灶与95%等剂量线的关系,若复发灶95%以上(包括95%)的体积在95%等剂量线内,判断为野内复发,20%以上(包括20%)～95%以下体积在95%等剂量线内,边缘复发,20%以下体积在95%等剂量线内,野外复发。结果:共收集了40例可供分析的患者,其中15例患者材料完整可供局部复发灶和照射野模拟剂量学分析。局部复发的主要部位为鼻咽腔、颅底骨质;局部复发灶和照射野模拟剂量学分析发现野内复发9例,边缘复发4例,野外复发2例。6例边缘和野外复发的患者,经过进一步分析发现复发与未严格遵循常规设野原则或对病灶范围判断失误造成不适当的照射野边界导致靶区出现低剂量区有关。结论:常规鼻咽癌面颈联合野和耳前野照射范围基本是合理的。
BACKGROUND ＆ OBJECTIVE： The lateral faciocervical field, lateral facial field, and cerrobent blocks were employed conventionally in radiotherapy of nasopharyngeal carcinoma （NPC） in Cancer Center of Sun Yat-sen University since 1990s. This study was to explore rationality of irradiated area of lateral faciocervical field and lateral facial field through analyzing the data of some patients presenting Iocoregional recurrence after conventional radiotherapy. METHODS. Clinical data of the patients, treated in 1999 and presented Iocoregional failure and had reports of CT examinations before and after radiotherapy and after recurrence, were reviewed. The regions of recurrent lesions were analyzed. Dosimetric analysis of recurrent regions was performed for the patients with available data of irradiating fields. If no less than 95% of the volume of local recurrent lesion was within 95% isodose curve, it was defined as in-field failure; 20% to less than 95% of the volume was within 95% isodose curve as marginal failure; less than 20% of the volume was within 95% isodose curve as out-field failure. RESULTS. Clinical data of 40 patients could be analyzed, and dosimetric analysis of recurrent regions was performed for 15 patients. Local recurrences mainly occurred in the nasopharyngeal cavity and the skull base bone. Dosimetric analysis showed 9 cases of in-field failure, 4 cases of marginal failure, and 2 cases of out-field failure. For the 6 cases of marginal and out-field failure, the main reasons of recurrence were low dose area in target volume due to not strictly following the guidelines of defining field limit, or inappropriately estimating the involved regions of lesions. CONCLUSION： Irradiated area of lateral faciocervical field and lateral facial field employed conventionally in radiotherapy of NPC is rational.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2006年第2期209-211,共3页
Chinese Journal of Cancer
关键词
鼻咽肿瘤/放射疗法
外照射
照射野
复发区域
Nasopharyngeal neoplasms
Radiotherapy
External beam irradiation
Irradiation field
Recurrence region
