鼻咽癌患者调强放疗前后垂体激素水平的变化研究

Change of Pituitary Hormone in Nasopharyngeal Carcinoma after Intensity Modulated Radiation Therapy

目的探讨鼻咽癌患者调强放射治疗前后垂体激素水平的变化情况。方法选取93例鼻咽癌患者作为研究对象。患者经CT扫描后,采取直线加速器6MV X线放疗,患者经CT扫描、勾画垂体、激素检测过程,检测GH、LH、FSH、PRL、TSH浓度,分析垂体受照射剂量情况。结果 TPS计算结果显示患者垂体体积越大所受照射剂量越小;患者不同时间GH、LH、FSH及TSH水平均处于正常范围内。100%垂体体积照射剂量<2 000 c Gy时,治疗结束时患者PRL水平高于正常范围,其他时间患者PRL水平在正常范围内;照射剂量<2 000 c Gy时,患者治疗前与治疗结束时GH、TSH水平具有统计学差异(P<0.05),治疗结束时与复查时PRL、FSH、TSH水平具有统计学差异(P<0.05),治疗前与复查时比较GH水平具有统计学差异(P<0.05);照射剂量为2 000~4 000 c Gy时,治疗结束时与复查时比较,FSH水平具有统计学差异(P<0.05),治疗前与复查时GH、FSH水平具有统计学差异(P<0.05);照射剂量为≥4 000 c Gy时,患者治疗前与治疗结束时GH水平具有统计学差异(P<0.05),治疗结束时与复查时TSH水平具有统计学差异(P<0.05),治疗前与复查时GH水平具有统计学差异(P<0.05)。结论鼻咽癌患者调强放射治疗前及治疗后垂体激素水平发生明显变化,但并未发生激素缺乏。

Objective To explore the change of pituitary hormone in nasopharyngeal carcinoma after intensity modulated radiation therapy. Methods 93 cases of nasopharyngeal carcinoma received CT scan,and radiation by linear accelerator 6MV X ray,the patients were tested by CT scan,outline the pituitary gland,hormone test. The GH,LH,FSH,PRL,TSH were tested,the pituitary irradiation dose were analyzed. Results The TPS results showed that the greater the pituitary volume,the smaller the dose; The levels of GH,LH,FSH,TSH were in normal range at different time. When the pituitary gland volume was 100%,irradiation dose < 2 000 c Gy,the level of PRL was higher than normal range,other times,the level of PRL was in normal range; When the irradiation dose < 2 000 c Gy,there was significant difference in the level of GH,TSH( P < 0. 05); There was significant difference in the levels of PRL,FSH,TSH before and after treatment( P < 0. 05); There was significant difference in the levels of GH after treatment and review( P < 0. 05); When the irradiation dose was 2 000 ~ 4 000 c Gy,there was significant difference in the level of FSH after treatment and review( P < 0. 05),There was significant difference in the levels of GH,FSH before treatment and review( P < 0. 05); When the irradiation dose ≥4 000 c Gy,there was significant difference in the level of GH before and after treatment( P < 0. 05); There was significant difference in the level of GH before and after treatment( P < 0. 05),there was significant difference in the level of TSH before and after treatment( P < 0. 05),there was significant difference in the level of GH( P <0. 05). Conclusion The level of pituitary hormones has significant change after IMRT in nasopharyngeal carcinoma,there has no hormone deficiency.