鼻咽癌放疗中头颈部体积变化与靶区及腮腺体积变化

To Analysis the Changes of Volume for Head and Neck, Parotid Gland and Gross Target for Nasopharyngeal Carcinoma during Treatment

目的 根据鼻咽癌治疗过程中不同节点的CT图像,研究头颈部体变化及靶区和腮腺体积变化。方法 入组15例调强放射治疗的鼻咽癌患者。在诱导化疗前,放疗前,放疗至剂量45-55 Gy,以及放疗结束分别扫描CT图像。勾画出头颈部,颈部外轮廓,靶区和腮腺,计算出其体积。根据体积数据分析体形变化与靶区及危及器官体积变化,以期找到变化的最大的阶段,来进行人为干预。结果 从放疗前到放疗剂量45-53 Gy,颈部体积前后有明显差异。靶区及危及器官也有明显差异。颈部、左腮腺、右腮腺、鼻咽肿瘤、左颈部肿瘤、右颈部肿瘤前后比较t值分别为4.26,13.23,13.23,5.86,3.93,5.93（均P〈0.05）。结论从放疗前到放疗剂量45-53 Gy,颈部有明显体积变化。应根据患者的实际情况,进行护理干预,尽量减少体形的缩小。否则应采用自适应放射治疗以保证治疗的精确性。

Objective According different CT images to analysis the changes of volume for head and neck, parotid gland and gross target during treatment for nasopharyngeal carcinoma. Methods 15 patients were enrolled for nasopharyngeal carcinomaduring treatment. For each patients, there were 4 serials CT being scanned, including previously treatment, previously radiotherapy, the close were 45-53 Gy and after radiotherapy. We contoured the body of head and neck, neck, target and parotid gland, then calculated the volume. According the changes of volumes, we evaluated the largest change phase and hope nursing intervention decrease the changes.. Results During the close were 45-53 Gy, there are significant differences for head and neck, neck, target and paroticl to previously radiotherapy. The t values were 4.26, 13.23, 13.23, 5.86, 3.93, 5.93 （P〈0.05） for neck, left parotid gland, right parotid gland, gross target volume, left neck gross target volume and right neck gross target volume. Conclusion During delivered 45-53 Gy. there were the large changes of volume to previously radiotherapy for region of interest （ROIs） for nasopharyngeal carcinoma treatment. In clinical practice, nursing intervention to decrease the changes is important for precise radiotherapy. Otherwise, we should take adaptive radiotherapy.