鼻咽癌放疗后放射性脑病65例临床分析

Clinical analysis about 65 cases of nasopharyngeal carcinoma with radiation encephalopathy after radiotherapy

目的:探讨鼻咽癌放疗后放射性脑病的MRI特征。方法:收集2008年1月-2011年9月确诊为放射性脑病的65例鼻咽癌病例,分析其放射治疗方法,MRI及治疗效果。结果:65例放射性脑病患者76.9%有症状,中位潜伏时间为3年10个月,MRI显示81%的病灶分布在颞叶,11%的病灶位于脑干,8%在多叶。33例经治疗后多次复查MRI结果表现不一。结论:放射性脑病的发生与放疗总剂量、分割剂量等呈正相关,其发生部位与照射野的设计有关,多数在放疗后2-3年发生,其临床表现各异,主要与损伤发生部位有关,MRI是目前最优的检查方法。

Objective：To explore the characteristics of MRI of radiation encephalopathy （REP） after radiotherapy in nasopharyngeal carcinoma （NPC）.Methods：All 65 cases of NPC with diagnosis of REP from January 2008 to September 2011 were analyzed retrospectively.All patients were diagnosed on grounds of radiotherapy,MRI and therapeutic efficacy.Results：76.9％ patients had symptoms,and the median latency period was 3 years and 10 months.The MRI showed that 81％ of the radiation injury lesions situated in the temporal lobes,11％ of the lesions situated in brain stems,and 8％ of the lesions situated in multi-lobes,33 patients showed multiple manifestations in MRI.Conclusion：Radiation injury of brain in NPC patients after radiotherapy are related to total dose,fraction dose and field design.The latent period of this disease was from 2 to 3 years.MRI is the most effective mean of REP for diagnosis.