| 刘菊英,陈 薇,王丽君.鼻咽癌调强放疗优化颈部靶区对甲状腺功能保护的临床研究[J].中国肿瘤,2015,24(12):1031-1037. |
| 鼻咽癌调强放疗优化颈部靶区对甲状腺功能保护的临床研究 |
| The Study of Intensity Modulated Radiation Therapy(IMRT) for Nasopharyngeal Carcinoma in Optimizing Cervical Clinical Target Volume on the Protection of Thyroid Function |
| 投稿时间：2015-08-01 |
| DOI：10.11735/j.issn.1004-0242.2015.12.A016 |
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| 中文关键词: 鼻咽癌 调强放疗 放疗靶区 甲状腺 甲状腺功能减退症 |
| 英文关键词:nasopharyngeal carcinoma intensity modulated radiotherapy target region thyroid hypothyroidism |
| 基金项目:2013江苏省卫生厅科研项目（Q201302） |
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| 中文摘要: |
| 摘 要：［目的］ 对比鼻咽癌调强放疗颈部靶区优化与未优化对患者甲状腺功能的影响，为优化颈部临床靶区提供可行性依据。［方法］ 收集我院收治的接受根治性放射治疗的初治鼻咽癌患者70例，其中32例行颈部Ⅳ区照射范围优化，通过治疗计划系统（TPS）测算甲状腺照射的剂量学参数，并检测优化组与未优化组放疗前、放疗结束后3、6、12个月血清FT3、FT4、TSH 的浓度，比较两组患者间及不同临床分期和N分期间甲状腺的放疗剂量参数，评估颈部靶区优化对甲状腺功能保护的影响，并以Kaplan－Meier法进行生存分析。［结果］ Ⅳ区优化组与未优化组相比，显著性降低甲状腺的平均照射剂量Dmean和体积百分剂量V50（P＜0.05）；Ⅳ期患者甲状腺的平均照射剂量Dmean和体积百分剂量V50显著性高于其他各期别；N0~2期患者中Ⅳ区优化组甲状腺平均剂量Dmean和V50均显著性低于未优化组（P＜0.05）；放疗结束后12个月Ⅳ区优化组与未优化组甲减的发生率有显著性差异（P=0.008）；优化组与未优化组的生存率无统计学差异。［结论］ 鼻咽癌调强放疗颈部靶区优化能更好地保护患者甲状腺功能，降低甲减的发生率，提高生活质量，与未优化组相比近期疗效相似。 |
| 英文摘要: |
| Abstract：［Purpose］ To compare the effect of thyroid function between two groups which optimized or unoptimized in cervical clinical target volume(CTV) with IMRT for nasopharyngeal carcinoma(NPC)，and to provide the feasibility of optimizing the clinical target area of the neck. ［Methods］ A total of 70 cases of NPC treated with IMRT were collected，in which 32 cases were optimized by the neck region of Ⅳ. Radiation dose parameters of thyroid were estimated by TPS. Then testing the concentrations of FT3，FT4，TSH in serum before and after radiotherapy of 3，6，and 12 months. Meanwhile，radiotherapy dose parameters of thyroid were compared among different clinical stages and N stages. A survival analysis was performed with Kaplan-Meier method.［Results］ Compared with the non optimized group，the thyroid mean dose and volume percent dose V50 of the optimal group was significantly low(P<0.05).The thyroid mean dose and V50 of patients of stage Ⅳ were significantly higher than the other clinical stages，and among the N0~2 patients，optimization of CTV in the Ⅳ region significantly reduced the thyroid mean dose and V50. The rate of hypothyroidism was significantly different between two groups of 12 months after radiotherapy（P=0.008）. There was no significant difference in the survival rate between two groups. ［Conclusion］ The present study has demonstrated that optimization in the cervical CTV of NPC treated with IMRT can better protect patients of thyroid function，decreas hypothyroid，improve the quality of life. |
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