摘要
目的 :研究鼻咽癌 (NPC)放疗后局部复发 (localrelapse LR)的CT表现及其诊断价值 ,并从中探索LR的可能原因。方法 :收集 10 4例NPC患者LR的CT片 ,按其主要CT表现分为两组 :1.单纯鼻咽腔内LR ;2 .其他部位LR(可同时伴有鼻咽LR)。并对比二组LR的中位复发时间及活检阳性率。结果 :二组中位复发时间分别为 40个月、15 6个月。总活检阳性率为 5 6 .7%。两组活检阳性率分别为 10 0 %、39 2 % ,有统计学意义 (P <0 .0 0 1)。颅底LR局限于一侧者占 91.7% ,LR时的侧别与初发NPC同在一侧者占 86 .3%。在有颅底LR和 或颅内LR中 ,其初程放疗时的CT即呈肿瘤向上扩展表现者占 86 .7%。结论 :应充分发挥CT诊断LR的优势 ,而不应一味要求病理证实。提高颅底剂量和准确确定靶区 。
Purpose:To study CT manifestations and their value in diagnosing of local relapse(LR) in nasopharyngeal carcinoma (NPC) after radiotherapy and investigate possible LR causes.Methods:CT images of 104 patients with local relapse of nasopharyngeal carcinoma were collected and divided into 2 categories according to their CT manifestations:①only nasopharyngeal cavity LR; ②other regionss with LR with or without nasopharyngeal cavity LR. Positive rates of biopsy and the median relapse periods of LR in the two groups are compared with one another. Results:Their median duration from primary radiotherapy to LR are 40.0, and 15.6 months, respectively . Positive rates of the two groups nasopharyngeal biopsy are 100.0%, respectively , with significant statistically difference ( P <0.01). Their total biopsy positive rate is 56.7%. Cases of 91.7% of skull base LR was located on one side. CT images during first radiotherapy depicting upward infiltrating appeared in 86.7% for hlapsing infiltration of skull base and intracranial cavity. When LR took place, 86.3% recurrent lesions was located on the same side as the initial NPC.Conclusions:We should give full use of the superiority of CT rather than rely completely on biopsy for timely diagnosing LR. It is possible to lower LR incidences by defining correct target volume as well as giving correctly a higher boost to skull base.
出处
《中国癌症杂志》
CAS
CSCD
2000年第5期391-393,共3页
China Oncology
