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目的评价不同放射治疗方式对鼻咽癌患者腮腺功能的损伤状况。方法常规分割(CF)组175例,总量70Gy;后程加速超分割放射治疗(LCAF)组63例,先用CF照射36～40Gy,再用LCAF照射35～40Gy,总量75Gy;调强适形放射治疗(IMRT)组142例,处方剂量72Gy。放射治疗期间观察急性放射性腮腺炎发生情况,2年后测定腮腺静止性分泌功能。结果IMRT组的腮腺受照射剂量远远低于其他两组。CF组、LCAF组和IMRT组急性放射性腮腺炎发生率分别为23.4%、41.3%和20.4%,差异有统计学意义(P<0.05)。2年后,CF组、LCAF组和IMRT组腮腺分泌功能下降率分别为81.7%、81.0%和69.7%,差异有统计学意义(P<0.05)。结论不同放射治疗方式对鼻咽癌患者的腮腺功能损伤程度不同,IMRT有利于覆盖肿瘤靶区,并使邻近敏感器官获得有效分割,使腮腺功能得到较好保护。
Objective To evaluate the damage of parotid gland function in patients with nasopharyngeal carcinoma under different radiotherapy modalities. Methods A total of 175 patients (70 Gy) underwent conventional fractionation (CF) and 63 patients underwent LCAF (accelerated accelerated radiation) 142 cases of conformal radiotherapy (IMRT) group, the prescription dose of 72Gy. Observation of acute radiation mumps during the occurrence of radiation mumps, parotid gland 2 years after the determination of static secretion. Results The dose of parotid gland in IMRT group was much lower than the other two groups. The incidence of acute mumps in CF group, LCAF group and IMRT group were 23.4%, 41.3% and 20.4%, respectively, with significant difference (P <0.05). After 2 years, the decrease rate of parotid gland secretion in CF group, LCAF group and IMRT group was 81.7%, 81.0% and 69.7%, respectively, with statistical significance (P <0.05). Conclusion Different radiotherapy methods have different degrees of parotid gland dysfunction in patients with nasopharyngeal carcinoma. IMRT is beneficial to cover the tumor target area and effectively divide adjacent sensitive organs so that parotid function can be well protected.