鼻咽癌放射治疗视觉通路PRV的探讨

Study on the nasopharyngeal carcinoma radiotherapy with the PRV of dangerous organ of eyes

目的研究鼻咽癌在常规放疗、适形调强放疗和全程调强放疗中,视觉通路危险器官的PRV确定,特别是晶体的PRV确定和剂量控制。方法我院自2005.7.1直线加速器开展精确放疗以来,进行鼻咽癌治疗病例55例,用1-2个周期的DDP+5-Fu新辅助诱导化疗后,进行分组治疗。A组:常规放疗,B组:适形+调强放疗,C组:全程调强放疗。考虑到眼球在5-10分钟的放疗过程中眼的不自主的活动,根据30例肿瘤患者和30例正常人群的眼的活动度的测定,确定眼的活动范围,并对眼晶体、眼球、视神经等视觉通路的PRV进行勾画并TPS计算的剂量结果比较。结果由于眼的活动,进行合理的眼各部位PRV确定对可以较好的避免眼晶体和其他视路的放射损伤,确保精确放疗除了对靶区能达到临床的控制要求的同时,还对危险器官能更好的保护。

Objective study on the nasopharyngeal carcinoma in conventional radiotherapy, conformal intensity-modulated radiotherapy and full intensity-modulated radiotherapy way, how the dangerous organs PRV are identified, particularly the identification of crystal PRV and dose-controL Methods since 2005.7.1,our hospital launching precision linear accelerator radiotherapy, 32 cases of nasopharyngeal carcinoma patients have been treated with DDP ＋5- Fu for 1-2 cycles of neoadjuvant chemotherapy,after then treatment divided into groups .Group A ： conventional radiotherapy, Group B ： conformal ＋intensity-modulated radiotherapy, Group C ： full intensity-modulated radiotherapy; Taking into account that the process of eyeballs in 5-10 minutes in the eyes of involuntary activities radiotherapy, 30 cases of eye cancer patients or normal activity are measured to determine the scope of activities of the eyes, and the caculated dose results from various outlined TPS of eye lens, eyeball and optic nerve are compared. Results Due to the eyes＇ activity, the reasonable PRV identified of the each part of the eyes can well avoid the radiation injury to eye lens and other inspect pathway, exact radiotherapy can not only achieve the clinical control requirements of the target, but also can dangerous organs he better protected.