| 刘雅恬,卞秀华,钱普东.局部晚期鼻咽癌调强放疗后颈动脉损伤的临床分析[J].肿瘤学杂志,2014,20(7):542-545. |
| 局部晚期鼻咽癌调强放疗后颈动脉损伤的临床分析 |
| An Analysis of Carotid Artery Injury After Intensity-modulated Radiation Therapy in Patients with Locally Advanced Nasopharyngeal Carcinoma |
| 投稿时间：2014-01-09 |
| DOI：10.11735/j.issn.1671-170X.2014.07.B003 |
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| 中文关键词: 鼻咽肿瘤 调强放疗 颈动脉损伤 |
| 英文关键词:nasopharyngeal neoplasms intensity-modulated radiation therapy carotid artery injury |
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| 中文摘要: |
| 摘 要：［目的］ 探讨局部晚期鼻咽癌调强放疗与颈动脉损伤的关系。［方法］系统随访91例Ⅲ~Ⅳa期鼻咽癌初治患者。全组患者均采用调强放疗技术（原发灶总剂量70~72Gy/32f，42~44d；颈淋巴结转移灶65~68Gy/32f，42~44d；高危预防区域60Gy/32f，42~44d；低危预防区域50Gy/28f，35~38d）放疗结束后定期通过磁共振颈血管成像（MRA）和/或颈部血管彩色多普勒随访患者颈动脉损伤发生情况。［结果］至随访截止日，91例患者中共有20例在MRA和/或颈部血管彩色多普勒上表现出颈动脉损伤，发生率为22.0%，1年、2年、3年、4年的发生率分别为11.0%（10/91）、16.5%（15/91）、20.9%（19/91）、22.0%（20/91），其中有10例患者同时进行了MRA及颈部血管彩色多普勒检查，6例患者颈部血管彩色多普勒的阳性结果出现在MRA之前，3例患者仅颈部血管彩色多普勒有阳性结果，1例两者同时发现颈部血管损伤。发生损伤的主要部位为颈总动脉（12例）、椎动脉（11例）及颈内动脉（6例）。［结论］局部晚期鼻咽癌患者调强放疗后颈动脉损伤的发生率高，联合多种影像学检查定期复查可以及早发现放疗后颈动脉损伤。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the relationship between carotid artery injury and intensity-modulated radiation therapy（IMRT） in patients with locally advanced nasopharyngeal carcinoma. ［Methods］ A cohort of 91 initial treated cases with stage Ⅲ ～Ⅳa nasopharyngeal carcinoma was followed up. The patients were treated with IMRT (70～72Gy/32f，42～44d for primary site；65~68Gy/32f，42～44d for lymph node metastasis；60Gy/32f，42～44d for high risk regions；50Gy/28f，35～38d for low risk regions). The carotid artery injuries were followed up periodically with MRA and/or ultrasound post-radiation. ［Results］ Twenty out of 91 patients demonstrated carotid artery injuriy either in MAR or ultrasound imaging，with incidence of 22.0%. The 1-year，2-year，3-year and 4-year incidence was 11.0%（10/91），16.5%（15/91），20.9%（19/91）and 22.0%（20/91）respectively. Ten patients evaluated with both MRA and ultrasound imaging，6 patients demonstrated positive findings on ultrasound imaging before MRA，3 patients demonstrated positive finding only on ultrasound imaging，1 patient had positive findings on both images. The common locations of carotid artery injury were common carotid artery (12 cases)，vertebral artery (11 cases) and internal carotid artery( 6 cases). ［Conclusion］ There is a high incidence of carotid artery injury after IMRT in locally advanced nasopharyngeal carcinoma. Combination of multiple imaging examinations periodically might contribute to early detection of carotid artery injury post-radiation. |
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