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中华放射肿瘤学杂志
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中华放射肿瘤学杂志  2021, Vol. 30 Issue (1): 11-15    DOI: 10.3760/cma.j.cn113030-20200122-00030
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鼻咽癌放射性甲状腺功能减退的相关因素研究
周凌1, 陈佳2, 黄爽3, 陶嫦娟3, 沈伟4, 陈明3, 余忠华5, 陈媛媛3
1广东医科大学第一临床医学院,湛江 524000;
2上海市医疗图像与医学知识图谱人工智能重点实验室 200050;
3中国科学院大学附属肿瘤医院/浙江省肿瘤医院放疗科 中国科学院肿瘤与基础医学研究所 浙江省放射肿瘤学重点实验室 精准放疗浙江省工程研究中心,杭州 310022;
4杭州依图医疗技术有限公司医疗研究院 330106;
5广东医科大学附属医院肿瘤中心,湛江 524001
Study of related factors of radiation-induced hypothyroidism in nasopharyngeal carcinoma
Zhou Ling1, Chen Jia2, Huang Shuang3, Tao Changjuan3, Shen Wei4, Chen Ming3, Yu Zhonghua5, Chen Yuanyuan3
1The First Clinical Medical College, Guangdong Medical University, Zhanjiang 524000, China;
2Shanghai Key Laboratory of Artificial Intelligence for Medical Image and Knowledge Graph, Shanghai 200050, China;
3Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Zhejiang Provincial Key Laboratory of Radiation Oncology, Zhejiang Engineering Research Center of Precision Radiotherapy, Hangzhou 310022, China;
4Hangzhou Yitu Medical Technology Co., Ltd. Medical Research Institute, Hangzhou 330106, China;
5Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, China
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摘要 目的 通过分析甲状腺剂量学参数,探索放疗后甲状腺功能减退(甲减)的主要因素,寻找甲状腺最佳剂量参数。方法 收集中国科学院大学附属肿瘤医院206例鼻咽癌放疗患者的一般临床特征及甲状腺、垂体剂量学参数,分析与甲减发生率的相关性。结果 鼻咽癌患者放疗后甲减发生率为50.49%(104/206),单因素分析显示性别、N分期、甲状腺体积、Dmean、V20Gy、V25Gy、V30Gy、V35Gy、V40Gy、V45Gy与甲减发生率相关,多因素分析显示甲状腺体积≤12.82 cm3、Dmean是甲状腺功能的独立预测因素。甲状腺Dmean联合体积可显著预测放疗后甲减发生率。结论 甲状腺Dmean≤47.21Gy是放射性甲减的最佳剂量参数,尤其是甲状腺体积≤12.82cm3患者更需关注放疗过程中对甲状腺的保护。
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作者相关文章
周凌
陈佳
黄爽
陶嫦娟
沈伟
陈明
余忠华
陈媛媛
关键词 鼻咽癌/放射疗法放射性甲状腺功能减退    
AbstractObjective To explore the main factors of hypothyroidism after radiotherapy and to identify the optimal thyroid dosimetric parameters by analyzing the dosimetric parameters of the thyroid. Methods The general clinical characteristics and dosimetric parameters of 206 patients with nasopharyngeal carcinoma treated in Cancer Hospital of University of Chinese Academy of Sciences were collected, and the correlation between them and the incidence of hypothyroidism was analyzed. Results The incidence of hypothyroidism in patients with nasopharyngeal carcinoma after radiotherapy was 50.49%(104/206). Univariate analysis showed that gender, N-stage, volume, mean dose, V20Gy, V25Gy, V30Gy, V35Gy, V40Gy, V45Gy of thyroid were associated with the incidence of hypothyroidism. Multivariate analysis demonstrated that volume (≤12.82cm3) and mean dose of thyroid were the independent risk factors of hypothyroidism. Mean dose of thyroid combined with volume could significantly predict the incidence of hypothyroidism after radiotherapy. Conclusion Mean dose of thyroid ≤ 47.21Gy is the optimal dosimetric parameter for radiation-induced hypothyroidism, especially the patients with thyroid volume ≤ 12.82 cm3 should pay more attention to the protection of thyroid gland during radiotherapy.
Key wordsNasopharyngeal carcinoma/radiotherapy    Radiation-induced hypothyroidism   
收稿日期: 2020-01-22     
基金资助:国家自然科学基金(81672971);浙江省医药卫生科技项目(2020RC044)
通讯作者: 陈媛媛,Email:chenyy@zjcc.org.cn;余忠华,Email:zhonghua_yu@126.com   
引用本文:   
周凌,陈佳,黄爽等. 鼻咽癌放射性甲状腺功能减退的相关因素研究[J]. 中华放射肿瘤学杂志, 2021, 30(1): 11-15.
Zhou Ling,Chen Jia,Huang Shuang et al. Study of related factors of radiation-induced hypothyroidism in nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2021, 30(1): 11-15.
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