鼻咽癌患者调强放疗对早期认知功能的影响

Influence of intensity-modulated radiotherapy for nasopharyngeal carcinoma on cognitive function

目的探讨调强放疗对鼻咽癌患者放疗后早期认知功能的影响。方法前瞻性分析2012年12月至2013年5月经病理活检确诊为鼻咽癌并接受调强放疗的初治患者52例,在CT定位图像上分别勾画左右侧颞叶,从剂量体积直方图(DVH)获取其受照射的剂量。采用DN-认知评估系统(DN-cognitive assessment system,DN-CAS)评价患者放疗前后的认知功能,并用配对t检验进行分析和比较。结果患者左侧颞叶、右侧颞叶的平均受照射剂量分别为(17.5±7.3)Gy、(18.2±6.8)Gy。鼻咽癌患者放疗后在DN-CAS量表中的计划、同时性加工、注意、继时性加工分量表的标准分与放疗前相似(P>0.05)。结论鼻咽癌患者调强放疗后早期的认知功能并未发生明显改变,但放疗后的长期影响值得关注。

Objective To explore the influence of intensity-modulated radiotherapy（IMRT） on cognitive function in patients with nasopharyngeal carcinoma（NPC）. Methods Between December 2012 and May 2013, patients with pathologically diagnosed NPC scheduled to receive IMRT were included.Dose-volume histograms of the temporal lobes were obtained for every patient, and the Das Naglieri Cognitive Assessment System（DN-CAS） was used to assess cognitive function before and after radiotherapy.Differences in cognitive function between patients were analyzed using the paired t-test. Results Mean radiation dose was（17.5±7.3）Gy to the left temporal lobe and（18.2±6.8）Gy to the right temporal lobe. Standardized scores on all DN-CAS subtests（Planning, Attention, Simultaneous, and Successive cognitive processes） were similar before and after radiotherapy（P〉0.05）. Conclusions IMRT did not induce any acute changes in cognitive function of NPC patients. Future studies with longer follow-up should further evaluate the poten-tial effects of radiotherapy on the cognitive function of NPC patients.