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目的探讨鼻咽癌常规放疗后放射性后组颅神经损伤(RILCN)的危险因素,以指导鼻咽癌放疗计划的制定。方法采用1∶2配对的病例对照研究,回顾性分析100对接受根治性放射治疗的鼻咽癌患者,应用条件Logistic回归模型分析可能影响RILCN形成的因素。结果选入回归方程的因素有吸烟、照射方法、上颈部照射剂量、颈部纤维化和颈部皮肤急性放射毒性,其危险度比分别为4·594、2·629、1·072、4·141和2·531。结论吸烟、照射方法、上颈部照射剂量、颈部纤维化和颈部皮肤急性放射毒性是RILCN发生的危险因素。建议停用耳前野加全颈切线野的照射方式。
Objective To investigate the risk factors of cranial nerve injury (RILCN) after radiotherapy in patients with nasopharyngeal carcinoma (NPC) in order to guide the development of NPC radiotherapy plan. Methods A case-control study of 1: 2 matching was performed. 100 patients with nasopharyngeal carcinoma undergoing radical radiotherapy were retrospectively analyzed. Logistic regression analysis was used to analyze the factors that may affect the formation of RILCN. Results The factors of the regression equation included smoking, irradiation method, irradiation dose on the upper neck, neck fibrosis and acute radiation toxicity on the neck skin. The hazard ratios were respectively 4.594, 2.62.9, 1.072, · 141 and 2 · 531. Conclusions Smoking, irradiation methods, upper cervical irradiation dose, cervical fibrosis and acute radiotoxicity of cervical skin are the risk factors of RILCN. It is recommended to disable the ear before wild plus full neck tangential field exposure.