dwiadc早期预测和动态检测头颈部肿瘤患者放疗过程中放疗对腮腺分泌功能影响的前瞻性临床研究word格式论文.docx

DWI—ADCforearlypredictionanddynamicdetectionofparotidglandsecretioninpatientswithheadandneckcancerduringradiotherapy：aprospectiveclinicalstudyAbstract：bjective：TostudythedynamicchangesofADCvalueofbilateralparotidglandinpatientswithheadandneckcancerduringadaptiveradiationtherapy(ART)，andtoexplorethecorrelationbetweenthechangesofADCvalueandtheradiationdose，volumewithdrawalandthefunctionofglandsecretion，provideanewmethodtoevaluatethefunctionofsalivaryglandintheearlystage，andtoguidetheclinicalprotectionoftheparotidgland．Methods：60headandneckcancerpatientstreatedwithintensitymodulatedradiotherapywereenrolledinthisprospectivestudyfromJun．2015toOct．2015．Thesalivaryglandcancerpatientswerenotincluded．DWIinvestigationswereperformedon3．0TMRI(b=O，500，800s／mm2)atpre-radiation，the15thradiation，the25th radiationandpost-radiation．ADCvaluesweremeasuredinthelargestcrosssectionofdeepandsuperficiallobes forparotidglandsrespectively(deeplobeofipsilateral：P1；superficiallobeofipsilateral：P2；deeplobeofcontralateral：P3；superficiallobeofcontralateral：P4)．Chewingstimulatestest，radionuclidescanandRTOGcriteriawereusedtoevaluatethesecretfunctionweekly．PearsonanalysiswasusedtoassessthecorrelationbetweenADC，deliveredradiationdose，volumeregression，andsecretfunctionofparotidglandsduringthecourseofradiotherapy．Results：-3．万方数据AllthepatientsexhibitedmeanADCincreasein parotidglands，withmeanincreasedratiosof0．37+0．15(P1)，0．35+0．13(P2)，0．35+0．17(P3)and0．35士O．09(P4)betweenpre·andpost—radiation．ADCchanges inspinalcordwerealmostinvisible(ratio_0．04+0．01)．Chewingstimulatestest，radionuclidescanandRTOGcriteriashoweddecreasesdsecretionfunctioninallpatientsatpost-radiation．TheincreasedmeanADChadastatisticalpositivecorrelationwiththeincreaseddelivereddose(r1=0．98；r2=0．96；r3=0．964；r4=0．947)，andhad asignificantly negative correlation withthe volumereduction(r1=-0．61；r2=一0．54；r3=一0．51；r4=一0．48)andsecretfunctionof parotidglands(rl=一0．74；r2=一0．71；r3=一0．69；r4=-0．68)．ThemeanADCofdeeplobe ofipsilateralparotidglandhadgreat