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目的:探讨图像引导调强放疗在头颈部肿瘤治疗中的应用价值。方法:回顾性研究2014年3月-2016年3月我院收治的50例头颈部肿瘤患者,其中IMRT(调强放疗)组与IGRT(图像引导调强放疗)组各25例,对比两组患者放疗的近期疗效急性毒性反应、摆位误差等。结果:50例患者中,通过CBCT1076次的扫描,所有数据呈正态性分布,其中大部分的患者摆位误差范围在-3mm~3mm之间,只有小部分的患者波动范围较大;IGRT与IMRT的摆位的误差显著,具有统计学意义(P<0.05)IGRT组放疗的急性毒副反应(急性皮肤反应、口腔黏膜、涎腺、咽、喉、急性骨髓抑制)毒性反应明显要比IMRT组低,比较差异显著(P<0.05);IGRT组的近期疗效为94.23%,与IMRT组的83.56%相比,IGRT组效果明显要比对照组高,两组患者差异明显(P<0.05)。结论:对头颈部肿瘤患者采用图像引导调强放疗,可以有效降低放射治疗中产生的摆位误差,毒性反应低,效果显著,值得推广使用。
Objective: To investigate the value of image guided intensity modulated radiotherapy in the treatment of head and neck cancer. Methods: A retrospective study of 50 patients with head and neck cancer admitted to our hospital from March 2014 to March 2016 was retrospectively studied. Among them, 25 cases were treated with IMRT and IGRT respectively, Short-term efficacy of radiotherapy in patients with acute toxicity, setting error and so on. Results: In 50 patients, all the data were normal distribution by 1076 CBCT scans. Most of the patients had a set error range of -3mm ~ 3mm, only a small part of the patients had a larger fluctuation range. The IGRT and The error of IMRT setup was significant and statistically significant (P <0.05). Toxicity of acute toxicity (acute skin reaction, oral mucosa, salivary gland, pharynx, larynx, acute myelosuppression) in IGRT group was significantly higher than that in IMRT group (P <0.05). The short-term curative effect of IGRT group was 94.23%. Compared with 83.56% of IMRT group, the effect of IGRT group was obviously higher than that of control group (P <0.05) . Conclusion: The use of image-guided intensity modulated radiotherapy for patients with head and neck cancer can effectively reduce the setup error caused by radiation therapy. The toxicity is low and the effect is significant, which is worthy of promotion.