论文部分内容阅读
[目的]分析鼻咽癌调强放疗(IMRT)后放射性颞叶损伤的影像及临床特点。[方法]回顾性分析单治疗组2005年3月至2012年1月初治260例无远处转移鼻咽低分化鳞癌患者行IMRT中发生放射性颞叶损伤患者的临床特点。[结果]共有32例患者发生影像学放射性颞叶损伤,其中7例为双侧同时或者先后发生,25例为单侧,均位于病变侧;8例有记忆力减退、多语和(或)颅内压增高等临床表现,24例无明显临床症状;仅3例患者进行了激素加抗水肿等治疗,余29例未行特殊治疗;至2015年5月仅1例患者死亡。根据MRI损伤分型,2型28例,1型4例。[结论]与常规放疗相比,鼻咽癌行IMRT后放射性颞叶损伤发生较早,但临床症状不典型,影像表现程度较轻,有自愈倾向,体现了IMRT在鼻咽癌治疗中对颞叶保护的作用。
[Objective] To analyze the imaging and clinical features of radiation-induced temporal lobe damage after IMRT in nasopharyngeal carcinoma. [Methods] The clinical characteristics of patients with IMRT in 260 patients with nasopharyngeal poorly differentiated squamous cell carcinoma without metastasis from March 2005 to January 2012 were retrospectively analyzed. [Results] Radiologic temporal lobe injury occurred in 32 cases, of which 7 cases were bilateral or simultaneous and 25 cases were unilateral, all located on the lesion side; 8 cases had memory loss, multilingual and / or cranial Increased pressure and other clinical manifestations, 24 cases no obvious clinical symptoms; only 3 patients were treated with hormone therapy and anti-edema, more than 29 cases without special treatment; to May 2015 only 1 patient died. According to MRI classification, 28 cases were type 2 and 4 cases were type 1. [Conclusion] Compared with the conventional radiotherapy, the nasopharyngeal carcinoma after IMRT radiotherapy of temporal lobe injury occurred earlier, but the clinical symptoms are not typical, the performance of the lesser extent, there is a tendency of self-healing, reflecting the IMRT in the treatment of nasopharyngeal carcinoma The role of temporal lobe protection.