调强放疗对中晚期鼻咽癌放射性脑损伤的相关影响

Intensity modulated radiotherapy for advanced nasopharyngeal cancer patients with radiation

目的大多数的鼻咽癌患者在发现时已为中晚期,放疗为鼻咽癌治疗首选治疗方法。由于病灶在头颈部,人们对放疗所导致的放射性脑损伤也日渐关注。本研究在研究调强放疗对中晚期鼻咽癌患者放射性脑损伤的相关影响,从而降低放射性脑损伤的发病率,提升患者的生活质量。方法将江苏省泰州市人民医院2014-01-2016-01收治的43例诊断为鼻咽癌患者作为研究对象,在模拟定位CT图像上勾画出靶区和危及器官,之后再分别给与患者调强放疗。43例患者在调强治疗前、治疗1周后及半年后均做头颅MIR检查并对患者的睡眠质量、精神状况进行评估,以观察患者的脑损伤情况。结果治疗前MIR显示放射性脑损伤及脑坏死患者0例,睡眠质量差者19例,患有轻度焦虑患者2例。在调强放疗半年后MIR显放射性脑损伤及脑坏死者9例,睡眠质量差者23例,患有轻度焦虑及症状加重者11例。结论调强放射后少数病例短期内肿瘤组织及其周围的脑组织会出现颅内压升高、脑水肿,但多数经治疗后症状会减轻或消失,然而患者的睡眠质量、精神状况受到明显的影响,出现嗜睡症状及轻度焦虑或者出现焦虑症状加重,长时间内部分患者会出现记忆力减退。

OBJECTIVE most of the patients with nasopharyngeal carcinoma(NPC)found in has in the late,radiotherapy for nasopharyngeal carcinoma(NPC)in the treatment of first choice in the treatment of.Due to lesions in the head and neck region,people of radiotherapy in radiation-induced injury of the brain also increasingly pay attention.The author intended to study of intensity modulated radiotherapy for advanced nasopharyngeal cancer patients with radiation brain injury related to the effect of,so as to reduce the incidence of radiation-induced brain injury,and improve the quality of life of the patients.METHODS January 2014-2016 January 43cases of diagnosis for the patients with nasopharyngeal carcinoma(NPC)as the object of study,in the simulation CT image outline target and organs at risk,respectively,after giving patients treated with intensity-modulated put Mir Mir Mir tone in the treatment of 43 patients before treatment,treatment a week later and half a year after the head check and the patients with sleep quality and mental health assessment,in order to observe the patients with brain injury.RESULTS before the treatment of radiation brain injury and necrosis of the brain in patients with 0cases,sleep quality is poor in 19 cases with mild anxiety patients in 2cases.In intensity modulated radiotherapy after six months of radiation brain injury and brain necrosis in 9cases,sleep quality is poor in 23 cases with mild anxiety and symptoms in 11 cases.CONCLUSIONS intensity modulated radiation after a small number of cases in the short term tumor tissue and surrounding brain tissue of intracranial pressure,brain Edema,but most after the treatment,the symptoms will reduce or disappear,however patients with sleep quality and mental health have obvious effect,appear sleepiness symptoms and mild anxiety or appear anxiety symptoms aggravated,long time in some patients will appear memory drops.