【作者】 张静；

【导师】 涂青松；

【作者基本信息】 中南大学 ， 临床肿瘤学， 2008， 硕士

【摘要】 目的:研究单侧茎突后间隙受侵的T_3-4N₀M₀Ⅲ-Ⅳa期鼻咽癌常规放疗和调强放疗中计划靶体积（PTV）及危及器官（OAR）的剂量学分布情况,为此期鼻咽癌的放射治疗提供物理学依据。方法:对五例单侧茎突后间隙受侵的T_3-4N₀M₀Ⅲ-Ⅳa期鼻咽癌患者分别进行头颈部CT和MRI扫描后,在Eclipse三维逆向治疗计划系统中进行图像的三维重建及融合,分别作出常规放疗计划和调强放疗计划,依据ICRU50号报告和62号报告提出的物理学指标进行评估。结果:1.常规计划的PGTVD₀₅、PTV1D₀₅高于调强计划;PGTVD₉₅、PTV1D₉₅、PTV1Mean、PTV2D₀₅、PTV2D₉₅、PTV2Mean均低于调强计划。2.常规计划中脊髓D₁、双侧腮腺D₅₀、双侧视神经D₁、双侧颞颌关节D₅₀、视交叉D₁、颞叶D₀₅高于调强计划;晶体D₀低于调强计划。3.常规计划中BodyDmean低于调强计划。结论:对于单侧茎突后间隙受侵的T_3-4N₀M₀Ⅲ-Ⅳa期鼻咽癌:1.调强计划中计划靶区的剂量分布优于常规计划;2.调强计划中脊髓、视神经、视交叉、腮腺、颞颌关节、颞叶剂量分布较常规计划有一定优势。3.调强计划中正常组织受照体积较常规计划增大。更多还原

【Abstract】 Objective:To make a guideline for radiatiotherapy of single side post styloid prosess parapharyngeal space（PSPS）invaded NPC in stage T_3-4N₀M₀,Ⅲ-Ⅳa with 92’Fuzhou Staging System,the different dose distribution of PTV and OAR were studied by comparing conventional radiatiotherapy plan with IMRT plan.Methods:After CT and MRI scanning of 5 PSPS invaded NPC patients,the image were restituted and syncretized in Eclipse External Beam Planning System,after that,we made the conventional radiatiotherapy plan and IMRT one for each patient to evaluate dose distribution according as ICRU 50 and 62 report.Results:1.PGTVD₅、PTV1D₀₅in convention plan is higher than IMRT, PGTVD₉₅、PTV1D₉₅、PTV1Mean、PTV2D₀₅、PTV2D₉₅、PTV2Mean in convention plan are lower than IMRT.2.Spinal cord D₁,optic chiasmaD₁,both sides of temporal lobe D₀₅, parotid D₅₀,optic nervesD₁,temporomandibular joints D₅₀are lower in IMRT plan;lens D₀ are higher in IMRT plan.3.Body Dmean is higher in IMRT plan.Conclusion:To single side PSPS invaded NPC in stage T_3-4N₀M₀,Ⅲ-Ⅳa: 1.Dose distribution in IMRT plan is better than the convention one.2.Dose distribution of spinal cord,optic chiasma,both sides of temporal lobe,parotids,optic nerves,temporomandibular joints and are better in IMRT pian。3.Volume of irradiated normal tussue is larger in IMRT plan.更多还原