摘要
目的观察不同放疗方式对患者颞颌关节损伤的影响,为不同条件的患者制定个体化的放疗计划提供参考。方法回顾性分析71例初治鼻咽癌患者,三维适形放疗(3D-CRT)组39例,适形调强放疗(IMRT)组32例,以门齿距及LENT SOMA标准为评价指标,比较两组之间疗效及性价比。结果 3D-CRT组近期局部控制率与IMRT组无差异(P=0.878);3D-CRT组的颞颌关节受量高于IMRT组(平均57.06 Gy和40.90 Gy,P<0.001);比较两组放疗后1年与放疗前门齿距差值,3D-CRT组缩小较明显,具有统计学意义(P<0.05);两组患者颞颌关节损伤按SOMA分级标准比较,无统计学差异(P>0.05)。结论相对于IMRT技术来说,3D-CRT技术具有很好的经济优势,颞颌关节的损伤可耐受,3D-CRT技术对于经济条件较差的患者仍是性价比较好的治疗选择。
Objective To compare the radiation injuries of the temporomandibular joint （TMJ） following three-dimensional conformal radiotherapy （3D-CRT） and intensity-modulated radiotherapy （IMRT） in patients with nasopharyngeal carcinoma （NPC）. Methods Thirty-nine NPC patients without previous radiotherapy underwent 3D-CRT and another 32 received IMRT in our institute. The distance between the 2 dens incisivus medialis （DDIM） and LENT SOMA criteria were employed to evaluate TMJ injuries, clinical outcomes, and the performance-to-price ratios. Results The short-term local response rates were similar between the two groups （P=0.878）. The mean radiation doses of the TMJ were significantly higher in 3D-CRT group than in IMRT group （57.06 vs 40.90 Gy, P〈0.001）. The DDIM showed significant changes in 3D-CRT groups after the radiotherapy （P〈0.05）. No significant difference was found in the TMJ injuries between the two groups according to the SOMA criteria （P〉0.05）. Conclusion Radiation injuries of the TMJ are tolerable in both 3D-CRT and IMRT groups, and 3D-CRT is a more economic choice for patients who can not afford IMRT.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2012年第7期991-994,共4页
Journal of Southern Medical University
基金
广东省医学科研基金(A2011287)
关键词
鼻咽肿瘤
三维适行放疗
调强适行放射治疗
颞颌关节
放射损伤
nasopharyngeal neoplasms
three-dimensional conformal radiotherapy
intensity-modulated radiation therapy
temporomandibular joint
radiation damage
作者简介
陈冬平，学士，副主任医师，E-mail：chen_dpgz@163．com
通讯作者：余意，硕士，主治医师，E-mail：onetwothreeok@126．com
