鼻咽癌常规放疗加后程三维适形放疗研究

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1、广西医科大学硕士学位论文鼻咽癌常规放疗加后程三维适形放疗研究姓名：黄江琼申请学位级别：硕士专业：肿瘤学指导教师：黎福祥;陈铭忠2003.5.1AStudyofConventionalRadiotherapyandThreeDimensionalConformalRadiotherapyonLatterCourseforNasopharyngealCarcinomaABSTRACTPurpose：Toev舔u莲fethetreatmentmethodofconventionalradiotherapyandth

2、reedimensionalconformalradiotherapyonlattercourse(CR+3DCRT)forpatientswi氇advancednasopharyngealcarcinomainordertoaidclinicaltherapy．Methodsandmaterials：DuringJanuary1999toOctober2002，36primarynasopharyngealcarcmomapatientsweretreatedbyCR+3DCRT．Allpatientsin

3、itiallyreceivedconventionalradiotherapy(CR)upto50—70GYofnasopharynxfollowedby"3DCRTtoboostupto8-35GY(mean19．4GY)．Timeoffollow-uplastedrange6to49months．AlsoCR+3DCRTtreatmentplanswerecomparedwithCRonradiotherapyplanninganddesigningsystemfor15patientsselecteda

4、trandomfrom36patients．Results：WithCR+3DCRT,．thevolumeofplanningtumortarget(PTV)includedover95％prescriptiondoseandthedoseof295％volumeofPTVobviouslyincreased，butthe5％PTVinthemaximumdoseregiondroppedobviously．Thedoseofparotidglands，temporo。mandibularjoints，bra

5、instemandtwoeyesdroppedaswell-Whenoverlapdistanceamongtargettospinalcordorbrainstem>10．5cm，patientswithinvadedposestyloidspacegotthedoseof95％targetvolume，whichincreasedby25·3％·1～2“yearsurvivalrateswere100％and95。6％respectively,and1--2-yeardistantmetastses—fr

6、eeratesandlocalcontr01area1197·2％ThereisnoGrade3or4acutetoxicityinallpatients。onlyonepatientexperienced3latetoxicityandtheothershadGr蠢纛etor2latetoxicity．Twopatientsdevelopedradiationencephalopathy．Conclusions：1。ThedoseofPTVWithCR+3DCRTwasmofehomogeneousthan

7、CR。Andthedoseofparotidglands，temporo-mandibularjoints,brainstemandandtwoeyesallhaveobviouslydecreased．2．Thereareveryeffective蛩reliminaryc娃nicaltreatmentresultswithinthegroup。3。Asnasopharynge曩tcarcinomapatients’posestyloidspacewereinvaded．、l蜷黼com脒涮CR+3CDRT．E

8、speciallywhenoverlapdistance3betweentargettospinalcordorbrainstemt>0．5cm，weconsiderthatCR+3DCRTcanbeusedforaroutinetherapy．4wesuggestthat3DCRTCanbetreatedonlyafterNPDT50GYofC＆andsingledivisiondoseof3DC