| 谢铁明,孔月,石磊,等.鼻咽癌患者放疗后记忆功能及影像学改变的临床分析[J].中华放射医学与防护杂志,2018,38(2):105-109.Xie Tieming,Kong Yue,Shi Lei,et al.Analysis of memory function and MRI changes in nasopharyngeal carcinoma patients after radiotherapy[J].Chin J Radiol Med Prot,2018,38(2):105-109 |
| 鼻咽癌患者放疗后记忆功能及影像学改变的临床分析 |
| Analysis of memory function and MRI changes in nasopharyngeal carcinoma patients after radiotherapy |
| 投稿时间：2017-06-01 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.02.005 |
| 中文关键词: 鼻咽癌 放射损伤 海马 颞叶 磁共振 |
| 英文关键词:Nasopharyngeal carcinoma Radiation-induced injury Hippocampus Temporal lobe MRI |
| 基金项目: |
| 作者 | 单位 | E-mail | | 谢铁明 | 310022 杭州, 浙江省肿瘤医院放射科 | | | 孔月 | 310022 杭州, 浙江省肿瘤医院放疗科 | | | 石磊 | 310022 杭州, 浙江省肿瘤医院放射科 | | | 杜锋磊 | 310022 杭州, 浙江省肿瘤医院放疗科 | | | 黄爽 | 310022 杭州, 浙江省肿瘤医院放疗科 | | | 花永虹 | 310022 杭州, 浙江省肿瘤医院放疗科 | | | 胡巧英 | 310022 杭州, 浙江省肿瘤医院放疗科 | | | 金厅 | 310022 杭州, 浙江省肿瘤医院放疗科 | | | 陈晓钟 | 310022 杭州, 浙江省肿瘤医院放疗科 | | | 陈媛媛 | 310022 杭州, 浙江省肿瘤医院放疗科 | chenyy@zjcc.org.cn |
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| 中文摘要: |
| 目的 分析局部晚期鼻咽癌患者放疗前、后记忆功能及脑磁共振影像学的改变。方法 回顾性分析2015年11月至2016年8月于浙江省肿瘤医院就诊的14例鼻咽癌患者的一般临床资料及剂量学资料，其中T2 1例，T3 7例，T4 6例，均接受2~3疗程PF/TP方案诱导化疗，及单药铂类同步调强放疗或TOMO治疗。比较放疗前及放疗后3个月数字广度测试及脑磁共振影像学的改变。结果 剂量学可分析资料患者9例，均采用调强放疗，海马Vmean（15.17±2.17）cm3，颞叶Vmean（95.07±12.26）cm3，海马Dmean（1 154.06±771.63）cGy，颞叶Dmean（1 306.61±603.69）cGy，海马Dmax（3 797.61±1 450.98）cGy，颞叶Dmax（5 394.17±982.28）cGy。海马生物等效均衡剂量（equivalent uniform dose，EUD）（2 233.28±872.73）cGy，颞叶EUD（3 113.11±603.69）cGy。10例患者放疗前、后正背均值分别为8.8±1.8和8.1±1.59（P>0.05），放疗前、后倒背均值分别为6.2±1.04和5.3±2.36（t=3.25，P<0.05）。9例患者在放疗前及放疗后3个月进行脑磁共振结构像扫描，双侧颞叶可观察到灰质体积萎缩（t=4.57，P<0.05）。结论 局部晚期鼻咽癌患者接受放疗，海马及颞叶均不可避免受到照射，放疗后，记忆功能部分受损，双侧颞叶灰质体积萎缩，两者间可能存在一定相关性，需进一步扩大样本量。 |
| 英文摘要: |
| Objective To analyse the memory function and MRI changes in local-advanced nasopharyngeal carcinoma patients before-and after-radiation.Methods Clinical data, dosimetric data, digital span score and MRI of 14 cases with nasopharyngeal carcinom treated in Zhejiang Cancer Hospital from November 2015 to August 2016 were retrospectively analysed. There were 1 case at T2 stage, 7 cases at T3 and 6 at T4. They received IMRT or TOMO therapy concurrent with 2 cycles Nedaplatin after 2-3 cycles PF/TP induction chemotherapy. Results The IMRT dosimetric data of 9 cases were available. For hippocampus and temporal lobe,the mean volume was (15.17±2.17) and (95.07±12.26) cm3, respectively, while the mean dose was (1 154.06±771.63) and (1 306.61±603.69) Gy,and the max dose (3 797.61±1 450.98) and (5 394.17±982.28) Gy, respectively. The equivalent uniform dose (EUD) was (2 233.28±872.73) Gy for hippocampus and (3 113.11±603.69) Gy for temporal lobe. 10 patients received digit span score before-and 3 months after-radiotherapy. The mean score of forward digit span was 8.8±1.8 before radiation and 8.1±1.59 at 3 months after radiation(P>0.05), while that of backward digit span decreased from 6.2±1.04 before radiation to 5.3±2.36 at 3 months after radiation (t=3.25, P>0.05). 9 patients' MRI were available. Volume reduction of temporal lobe was observed(t=4.57, P<0.01)by voxel-based morphometry (VBM).Conclusions Radiation-induced injury to hippocampus and temporal lobe is inevitable in local-advanced nasopharyngeal carcinoma patients. There might be some connection between memory loss and temporal lobe volume atrophy after radiotherapy. Enrollment of larger sample analysis is expected. |
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