| 李坚,王仁生,甘浪舸,等.鼻咽癌患者放疗后颈部纤维化及其影响因素[J].中华放射医学与防护杂志,2005,25(3):253-255.LI Jian,WANG Ren-sheng,GAN Lang-ge,et al.Radiation-induced neck fibrosis in patients with nasopharyngeal carcinoma[J].Chin J Radiol Med Prot,2005,25(3):253-255 |
| 鼻咽癌患者放疗后颈部纤维化及其影响因素 |
| Radiation-induced neck fibrosis in patients with nasopharyngeal carcinoma |
| 投稿时间：2004-04-12 |
| DOI： |
| 中文关键词: 鼻咽肿瘤 放射疗法 颈部 纤维化 放射损伤 |
| 英文关键词:Nasopharyngeal carcinoma Radiotherapy Neck Fibrosis Radiation damage |
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| 中文摘要: |
| 目的 观察鼻咽癌患者放疗后颈部纤维化的情况,探讨影响颈部纤维化的有关因素。方法 观察首程常规分割、连续放疗结束后半年至10年的鼻咽癌患者267例,所有患者颈部照射总吸收剂量50～72Gy。以颈部外形改变及功能活动为指标,组间差异采用卡方检验。结果 全组患者放疗后均出现程度不同的颈纤维化,重度颈纤维化的发生率为24.34%(65267),其中颈部预防量照射的发生率为2.74%,后程小野垂直照射的发生率为11.01%,后程半颈或全颈切线照射的发生率为60.00%。后程切线照射与非切线照射比较,差异有统计学意义(P<0.0001);坚持转颈锻炼和未锻炼者重度纤维化发生率差异无统计学意义(P>0.1),但患者转颈受限、侧颈困难、肌肉抽搐等主观功能感觉较未锻炼者相对轻;合并同期化疗未增加颈重度纤维化的发生率(P=0.2678),但出现时间提早2～5个月;后程6MV加速器切线照射致重度颈纤维化以颈部肌肉功能减弱为主,而60Coγ射线则以皮肤损伤更严重。结论 鼻咽癌患者放疗后颈部重度纤维化的发生率较高;高剂量和后程半颈或全颈切线照射是主要的影响因素;根治量照射时应尽量避免颈部的后程切线照射。 |
| 英文摘要: |
| Objective To investigate the post-irradiation neck fibrosis in patients with nasopharyngeal carcinoma and its related factors. Methods A total of 267 patients received conventional fractionated radiotherapy with D_T50-72 Gy on the neck a half year to 10 years ago were observed for the changes of cervical shape and functions. Results Different degrees of post-irradiation neck fibrosis were seen in all patients. The rate of heavy degree of neck radiation fibrosis was 24.34%,and it was 2.74% when received preventive dose on the neck. There was a very significant difference between patients who received late course of tangential irradiation on the neck and those who didn't receive (P=0.0001).The incidence of post-irradiation neck fibrosis didn't increase when patients received radiotherapy combined with chemotherapy(P=0.2678).The function of cervical muscles turned weak in patients received radiotherapy delivered by 6 MV accelerator in late course of tangential irradiation, whereas skin damage was severer in patients treated with 60Coγ-rays. Conclusion The incidence of heavy degree of post-irradiation neck fibrosis is high,and is related closely to late course of tangential irradiation. We should avoid adopting this sort of irradiation on the neck. |
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