鼻咽癌立体定向适形放疗腮腺受照剂量与口腔干燥症的关系

The relationship between xerostomia and radiation dose of parotid in nasopharyngeal carcinoma patients with stereotactic radiotherapy

目的:分析鼻咽癌立体定向放射治疗腮腺受照剂量与口腔干燥症发生的关系。方法:61例鼻咽癌接受立体定向放疗,照射靶区为鼻咽肿瘤、鼻咽区、咽旁间隙和颈部淋巴区,靶区处于95%剂量曲线内,总剂量30-42Gy/10-14次/20-30天。腮腺处于50%-60%剂量线内。复查时进行面对面访谈方式的口干问卷调查,根据调查结果分析口腔干燥症的严重程度。结果:全组1年局控率95.08%(58/61),1、2、3年累积生存率为95.08%(58/61)、93.22%(57/61)、90.16%(55/61)。左腮腺受照剂量15.98Gy-31.06Gy(21.21±5.29)。右腮腺受照剂量14.89Gy-26.69Gy(19.01±4.96),口腔干燥症的发生率为6.56%(4/61),中度发生率为3.28%(2/61),无重度发生。结论:单纯立体定向放射治疗鼻咽癌可以保证局部控制率和生存率,降低腮腺受照剂量,减少放疗后口腔干燥症。

Objective：To study the relationship between the xerostomia rate and the radiation dose of parotid in nasopharyngeal carcinoma（NPC） patients with stereotactic radiotherapy（SRT）. Methods： Sixty one naive NPC patients were treated with SRT,and the target, included the nasopharynx, the space around the parapharyngeal and the area of neck lymph node,were surrounded by 95% isodose curve and by 30 -42Gy/10 - 14f/20 -30 days. The parotid were surrounded by 50% - 60% isodose curve. All patients were given a questionnaire investigation of clinic regarding xerostomia after 1 year radiotherapy. The relationship between the xerostomia rate and the radiation dose of parotid were studied. Results： The local control rates was 95.08% （58/61）, and the 1 - ,2 - ,3 - year survival rate were 95.08% （58/61） ,93.22% （57/61） ,90.16% （55/61） respectively. The radiation dose of left and right parotid were 15.98Gy - 31.06Gy（ 21.21 ± 5.29） and 14.89Gy - 26.69Gy（ 19.01 ± 4.96） respectively. 6. 56 % （4/61） xerostomia was found. Moderate xerostomia were 3.28% （2/61）and no severe case occurred. Conclusion：The only stereotaetic radiotherapy can acquire the same local control rate and the survival rate for nasopharyngeal carcinoma. It also can decrease the rate of xerostomia and improve the quality of life.