CT模拟定位及三维适形放疗技术治疗鼻腔鼻窦恶性肿瘤效果分析

CT simulation positioning and three-dimensional conformal radiotherapy in the treatment of sinonasal malignant tumor

目的探讨CT模拟定位(CT simulation positioning)及三维适形放疗技术(Three-dimensional conformal radiotherapy,3-DCRT)治疗鼻腔鼻窦恶性肿瘤(sinonasal maliganant tumor)的效果。方法选取本院2012年3月—2014年3月间收治的鼻腔鼻窦恶性肿瘤患者120例进行研究,随机将其分为2组,即对照组(n=60)采用鼻内镜手术治疗,观察组(n=60)均采用模拟CT定位联合三维适形放疗技术予以治疗,比较2组患者的临床疗效。结果对照组患者术中平均出血量为(580±20.5)mL,随访24个月,观察组患者死亡率为13.33%,平均生存时间为(1.12±0.04)年,对照组患者死亡率为21.67%,平均生存时间为(0.75±0.20)年,两组数据对比差异显著P<0.05;两组患者治疗后其KPS评分较治疗前均显著改善,观察组患者改善幅度优于对照组,数据差异显著(P<0.05)。结论在鼻腔鼻窦恶性肿瘤手术治疗时采用CT模拟定位法和3-DCRT方法能显著降低术中出血量、延长患者的生存时间,提高其治疗效果,因此值得推广应用。

Objective To explore the efficacy of CT simulation positioning and three‐dimensional conformal radiotherapy （3‐DCRT ） in the treatment of sinonasal malignant tumor .Methods A total of 120 patients with si‐nonasal malignant tumor treated during March 2012 and March 2014 were enrolled .The patients were randomly di‐vided into two groups ：control group （n=60） treated with endoscopic sinus surgery ,and observation group （n=60） treated with CT simulation positioning combined with 3‐DCRT .The efficacy of the two approaches were compared . Results The average intraoperative bleeding of the control group was （580 ± 20 .5） mL .During the follow‐up of 24 months ,the mortality rate of the observation group and control group was 13 .33% vs .21 .67% ,the average survival time was （1 .12 ± 0 .04） vs .（0 .75 ± 0 .20） years .There were significant differences between the two groups （P〈0.05） .The KPS score was improved in both groups after treatment ,and the observation group had more improve‐ment than the control group （P〈0 .05） .Conclusions CT simulation positioning combined with 3‐DCRT can sig‐nificantly reduce the amount of blood loss and prolong the survival time of patients with sinonasal malignant tumor , so it is worth wide clinical application .