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目的:探讨CTVision调强放疗的精确性以及调强放疗结合化疗治疗鼻咽癌的近期疗效。方法:回顾性分析2010年5月至2012年1月收治的58例鼻咽癌患者的临床资料,采用CTVision调强放疗结合化疗。放疗方法:原发病灶70～76Gy、颈部淋巴结56～72Gy、高危区56～62Gy、低危区50～60 Gy。正常组织根据要求限量。化疗方法:诱导化疗为顺铂+5-氟尿嘧啶方案,同步放化疗为单药顺铂方案,辅助化疗为顺铂+5-氟尿嘧啶方案。放疗期间定期行图像引导,验证计划。结果:图像引导偏差值X、Y、Z方向的均值均为±1 mm,在可接受误差范围内(P<0.05)。CR 44例(75.86%)、PR 13例(22.41%)、CR+PR 57例(96.61%)。不良反应主要有放射性皮炎、放射性腮腺炎、口腔黏膜炎及口干,程度较轻;骨髓抑制发生较多且程度较重。结论:CTVision图像引导的调强治疗是一种精确的治疗方式,调强放疗联合化疗的方式治疗鼻咽癌效果良好。
Objective: To investigate the accuracy of CTVision IMRT and the recent curative effect of IMRT combined with chemotherapy in the treatment of nasopharyngeal carcinoma. Methods: The clinical data of 58 patients with nasopharyngeal carcinoma who were treated from May 2010 to January 2012 were retrospectively analyzed. The CTVision combined with radiotherapy and chemotherapy was used. Radiotherapy methods: the primary lesion 70 ~ 76Gy, cervical lymph node 56 ~ 72Gy, high-risk area 56 ~ 62Gy, low-risk area 50 ~ 60 Gy. Normal tissue is limited on request. Chemotherapy: Induction chemotherapy for cisplatin + 5 - fluorouracil program, concurrent chemoradiotherapy for monotherapy cisplatin regimen, adjuvant chemotherapy for cisplatin + 5 - fluorouracil program. Radiotherapy during regular line image guide, validation plan. Results: The average values of X, Y and Z directions of image guidance deviation were ± 1 mm, which were within acceptable error range (P <0.05). CR 44 cases (75.86%), PR 13 cases (22.41%), CR + PR 57 cases (96.61%). Adverse reactions are mainly dermatitis, mumps, oral mucositis and dry mouth, to a lesser extent; bone marrow suppression occurred more and more severe. Conclusion: CTVision image-guided IMRT is an accurate treatment. IMRT combined with chemotherapy is effective in treating NPC.