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体表面积变化对鼻咽癌放疗患者偏心颈椎点和面部剂量的影响。

Effect of Body Size Change on Off-Center Cervical Point and Face Doses in Patients Undergoing Nasopharyngeal Carcinoma Radiotherapy.

机构信息

Department of Radiotherapy, The First Affiliated Hospital of Bengbu Medical College, 287 Changhuai Road, Bengbu, Anhui Province, China.

Basic Medical College of Bengbu Medical College, 287 Changhuai Road, Bengbu, Anhui Province, China.

出版信息

Dis Markers. 2022 Apr 25;2022:9978282. doi: 10.1155/2022/9978282. eCollection 2022.

Abstract

Nasopharyngeal carcinoma (NPC) is a clinically multiple malignant tumor. At present, with the increase in the infection rate of Epstein-Barr virus, the incidence of nasopharyngeal carcinoma is also increasing day by day. To explore the effect of body size change on off-center cervical point and face doses in patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy, in total, 100 patients with NPC from January 2019 to May 2020 in our hospital were selected for retrospective analysis, and they all received intensity-modulated radiation therapy. Bodyweight, horizontal longitudinal diameter of the odontoid process, longitudinal diameter of the third cervical spine, maximum radiation dose, and average radiation dose of normal organs in the first and last treatments were assessed, and the correlation between normal organ irradiation dose and body size was analyzed. Bodyweight, horizontal longitudinal diameter of the odontoid process, and longitudinal diameter of the third cervical spine in the last treatment were lower than those in the first treatment, with a statistically significant difference. There was no statistically significant difference in the maximum normal organ irradiation dose to the left eyeball, right eyeball, left crystalline lens, right crystalline lens, and maximum irradiation dose to optic nerve between the last treatment and the first treatment. In the last treatment, the maximum dose to the left parotid gland, right parotid gland, spinal cord, and brain stem was higher than that in the first treatment. The average irradiation dose to the left eye bulb, right eye bulb, left lens, right lens, optic nerve in the last treatment, and that in the first treatment showed no significant difference. The average dose to the left parotid gland, right parotid gland, spinal cord, and brain stem in the last treatment was higher than that in the first treatment. The irradiation dose to the left parotid gland, right parotid gland, spinal cord, and brain stem was significantly negatively correlated with body weight, horizontal longitudinal diameter of the odontoid process, and longitudinal diameter of the third cervical spine. After NPC radiotherapy, the body size of patients can change, which can have different effects on irradiation doses. Therefore, the target area and dose should be corrected during treatment to ensure the efficacy and safety of the treatment.

摘要

鼻咽癌(NPC)是一种临床多发的恶性肿瘤。目前,随着 Epstein-Barr 病毒感染率的增加,鼻咽癌的发病率也日益增高。为探讨鼻咽癌(NPC)患者放疗过程中体质量变化对偏中心颈椎点和面剂量的影响,回顾性分析我院 2019 年 1 月至 2020 年 5 月收治的 100 例 NPC 患者,均行调强放疗,评估其首末两次治疗时的体质量、齿状突水平纵向直径、第 3 颈椎纵向直径、最大靶区剂量、正常器官的平均照射剂量,并分析正常器官照射剂量与体质量的相关性。末次治疗时的体质量、齿状突水平纵向直径、第 3 颈椎纵向直径均低于首次治疗,差异有统计学意义(P<0.05)。末次治疗与首次治疗时左侧眼球、右侧眼球、左侧晶状体、右侧晶状体的最大受照剂量、视神经最大受照剂量比较,差异无统计学意义(P>0.05)。末次治疗时左侧腮腺、右侧腮腺、脊髓、脑干的最大受照剂量高于首次治疗,差异有统计学意义(P<0.05)。末次治疗与首次治疗时左侧眼球、右侧眼球、左侧晶状体、右侧晶状体、视神经的平均受照剂量比较,差异无统计学意义(P>0.05)。末次治疗时左侧腮腺、右侧腮腺、脊髓、脑干的平均受照剂量高于首次治疗,差异有统计学意义(P<0.05)。左侧腮腺、右侧腮腺、脊髓、脑干的受照剂量与体质量、齿状突水平纵向直径、第 3 颈椎纵向直径呈显著负相关(P<0.05)。NPC 放疗后患者体质量可发生变化,对照射剂量有不同影响,因此在治疗过程中应校正靶区和剂量,以保证治疗的疗效和安全性。

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