三维适形放疗和适形调强放疗技术对鼻咽癌放疗后-南方医科大学学报.PDFVIP

2012;32(7) 南方医科大学学报（J South Med Univ ） ·991 · 临床研究 临床研究 三维适形放疗和适形调强放疗技术对鼻咽癌放疗后颞颌关节损 伤的影响 陈冬平，余 意，齐 斌，刘锦全，李铭仪，梁玉莹 广州医学院附属肿瘤医院放疗科，广东 广州 510095 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 ，P0.001) ；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（P0.05）；两组患者颞颌关节损伤按SOMA 分级标准比较，无统计学差异（P0.05）。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。 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 中图分类号：R739.61; R815 文献标志码：A 文章编号：1673-4254（2012）07-0991-04 doi: 10.3969/j.issn. 1673-4254.2012.07.019 /kcms/detail/44.1627.R1115.002.html Comparison of temporomandibular joint injuries after three-dimensional conformal and intensity-modulated radiotherapies for nasopharyngeal carcinoma CHEN Dongping, YU Yi, QI Bin, LIU Jinquan, LI Mingyi, LIANG Yuying Department of Radiotherapy, Guangzhou Medical University Cancer Institute and Hospital, Guangzhou 510095, China Abstract: 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