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目的探讨鼻咽癌(NPC)三维调强放疗(IMRT)中腮腺的受照射剂量。方法 IMRT放疗的NPC患者49例,通过剂量体积直方图(DVH)计算鼻咽原发灶(GTV1)、阳性颈淋巴结区(GTV2)的照射剂量、两侧腮腺接受一定剂量照射的体积(V25)以及两侧腮腺一定体积所受的照射剂量。结果 GTV1照射剂量(70.81±1.79)Gy,GTV2(65.84±1.94)Gy。腮腺V25照射剂量:左侧(93.78±5.96)%,右侧(93.60±13.46)%。腮腺50%体积所受的照射剂量:左侧(36.72±3.29)Gy,右侧(37.53±3.21)Gy。临床口干症状:1级5例,2级31例,3级13例。结论 NPB IMRT中腮腺的受照射剂量比常规放疗低;唾液腺得到较常规放射治疗很好的保护,但仍然不能解决口干的放射性损伤问题。
Objective To investigate the dose of the parotid gland in NPC three-dimensional IMRT. Methods Forty-nine patients with NPC treated by IMRT radiotherapy were enrolled in this study. The doses of GTV1 and GTV2 were calculated by dose-volume histogram (DVH) And parotid volume on both sides of the exposure dose. Results GTV1 irradiation dose (70.81 ± 1.79) Gy, GTV2 (65.84 ± 1.94) Gy. Parotid V25 irradiation dose: the left (93.78 ± 5.96)%, the right (93.60 ± 13.46)%. The parotid gland 50% of the volume of exposure dose: left (36.72 ± 3.29) Gy, right (37.53 ± 3.21) Gy. Clinical symptoms: 5 in grade 1, 31 in grade 2 and 13 in grade 3. Conclusion The dose of parotid gland in NPB IMRT is lower than that of conventional radiotherapy. Salivary gland is well protected by conventional radiotherapy, but it still can not solve the radioactive injury of oral cavity.