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目的:探讨鼻咽癌适形调强放疗(IMRT)后长期幸存者的认知功能、生活质量、情绪及其相互关系.方法:采用横断面调查分析在本院接受IMRT根治性治疗的54例鼻咽癌幸存者.使用蒙特利尔认知评估量表( MoCA)评估认知功能,情绪评估采用焦虑、抑郁自评量表,生活质量评估采用鼻咽癌专用癌症治疗功能评价系统( FACT-NP).结果:放疗后中位存活时间14. 5月(7月~6. 5年),中位年龄44. 5岁(18~71岁),34例(63. 0% )存在放疗后轻度认知功能障碍.教育水平越高,认知功能评分越高.双侧颞叶Dmax≥65Gy或V60≥1. 10cm3 是认知功能损伤的危险因素. MoCA量表评分与年龄、性别、吸烟饮酒史、合并症、情绪评分、AJCC分期、T分期、化疗方式、放疗后时间、生活质量评分均无相关性. 1例患者(1. 9% )有焦虑症状,4例患者(7. 4% )有抑郁症状.抑郁评分越高,生活质量评分越低.结论:鼻咽癌IMRT后长期幸存者轻度认知功能障碍较为常见,与教育水平和颞叶受照剂量相关.焦虑抑郁状态虽不常见,但却影响生活质量.“,”Objective: To study the cognitive function, quality of life (QOL) and moods of long-term survivors of naso-pharyngeal cancer (NPC) patients treated by intensity-modulated radiotherapy (IMRT). Methods: A cross-sectional study evaluating 54 NPC survivors with IMRT in our hospital was conducted. We used Montreal Cognitive Assessment (MoCA) to test the cognitive function, used FACT-NP to test QOL, and used the Hospital Anxiety and Depression Scale (HADS) to test mood. Results: Median survival time after IMRT was 14. 5 months (7 months~6. 5 years), and the median age was 44. 5 years (18~71 years). In total, 34 patients(63. 0% )were defined as mild cognitive impairment. Higher MoCA scores were associated with higher education level. Bilateral temporal lobe with Dmax ≥65 Gy or V60≥1. 10 cm3 was a risk factor for cognitive impairment. Age, gender, smoking and alcohol history, complicated diseases, mood scores, TNM stage, chemo-therapy, time after IMRT, QOL did not correlate with MoCA scores. One patient (1. 9% ) suffered from anxiety and 4 (7. 4% ) suffered from depression. The higher the depression score was, the lower the QOL score was. Conclusion: Mild cognitive impairment after IMRT is common in NPC survivors. Education level and radiation dose of temporal lobe were asso- ciated with cognitive function. Anxiety and depression are not common but will affect the QQL.