目的:探讨鼻腔内肿瘤调强放疗时舌的位置与剂量学关系。方法:对5例2011-11-02-2012-08-31华中科技大学同济医学院附属同济医院经病理和影像确诊局限于鼻腔内肿瘤患者,在治疗计划系统中测量舌到硬腭的距离并计算其剂量,测量5例患者142次治疗摆位完成后锥形束CT(conebeam CT,CBCT)影像中的舌到硬腭的距离,并在治疗计划系统中模拟计算舌在该位置的剂量。结果:治疗计划定位时舌到硬腭的距离为0.00~1.10cm,治疗摆位时为0.00~0.95cm,治疗时舌的位置与定位时的重合率仅为3.52%,各例患者舌位置差异均值在0.10~0.35cm,剂量差异最大可达30.01Gy。结论:局限于鼻腔内肿瘤调强放疗时,作为毗邻器官舌的位置不易重复和固定,导致剂量差异。建议采用适当形状和组织等密度材料的压舌板予以固定,使舌远离硬腭以减小其所受剂量。 Objective: To investigate the relationship between tongue position and dosimetry in intranasal tumor IMRT. Methods: Five cases of 2011-11-02 2012-08-31 Tongji Medical College Affiliated Tongji Hospital of Huazhong University of Science and Technology by pathology and imaging diagnosis limited to patients with nasal tumor, in the treatment planning system to measure the distance from the tongue to the hard palate and calculated The dose to measure the distance between the tongue and the palatal palate in conebeam CT (CBCT) images after 142 treatments were completed in 5 patients and to simulate the dose of the tongue in this position in the treatment planning system. Results: The distance between the tongue and the hard palate was 0.00 ~ 1.10cm when the treatment plan was located and 0.00 ~ 0.95cm when the treatment was placed. The coincidence of tongue position and positioning was only 3.52% In 0.10 ~ 0.35cm, the dose difference up to 30.01Gy. CONCLUSION: When confined to intranasal tumor IMRT, the position of the tongue adjacent to the organ is not easily repeated and fixed, resulting in dose differences. It is advisable to hold the spatula with a densified material of appropriate shape and tissue so that the tongue is kept away from the hard palate to reduce the dose it receives.