鼻咽癌IMRT海马头部、体部及尾部剂量分析

doi:10.3760/cma.j.issn.1004-4221.2017.11.003

摘要
图/表
参考文献()
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (2755 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

摘要

目的探讨鼻咽癌患者IMRT计划中海马头部、体部及尾部的受量。方法选取10例接受IMRT的鼻咽癌患者,在MRI T1加权相勾画左、右侧海马的头部、体部及尾部,提取照射剂量指标做比较。对海马头部、体部及尾部受量及受照体积比较行单因素方差分析,两两比较采用LSD法。WAIS-CR言语测试结果采用配对样本t检验。结果左、右侧海马的平均受量分别为(1147±976)、(1011±602) cGy。左侧海马头部、体部及尾部的平均受量分别为(1739±1317)、(890±982)、(547±688) cGy (P=0.042);右侧海马头部、体部及尾部的平均受量分别为(1691±942)、(744±483)、(531±603) cGy (P=0.002)。海马头部、体部及尾部受量依次减少,不同照射剂量受照体积也依次减少。结论鼻咽癌患者IMRT中海马头部、体部及尾部受量不同,海马头部受照量最高,值得临床关注。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	孙宗文
	石磊
	孔月
	杜峰磊
	谢铁明
	花永虹
	胡巧英
	陈晓钟
	陈媛媛
	陈明

关键词 ：鼻咽肿瘤/调强放射疗法, 放射治疗剂量, 海马

Abstract：

Objective To analyze the radiation doses to the head, body, and tail of the hippocampus in intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC). MethodsTen NPC patients treated with IMRT were selected, and the head, body, and tail of both hippocampi were delineated on T1-weighted images. The doses to the hippocampus were then analyzed. WAIS-CR speech test Resutls were tested by paired sample t-test. Resutls The mean doses to left and right hippocampi were 1147±976 cGy and 1011±602 cGy, respectively. The mean doses to the head, body, and tail of the left hippocampus were 1739±1317 cGy, 890±982 cGy, and 547±688 cGy, respectively (P=0.042);the mean doses to the head, body, and tail of the right hippocampus were 1691±942 cGy, 744±483 cGy, and 531±603 cGy, respectively (P=0.002).The dose to the hippocampus decreased from the head to the tail, and the irradiated volume also decreased as the dose varied. Conclutions The dose to hippocampus decreases from the head to the tail in NPC patients treated with IMRT, which is worthy of attention.

Key words： Nasopharyngeal neoplasms/intensity modulated radiotherapy Radiotherapy dosage Hippocampus

收稿日期: 2017-05-08

基金资助:

浙江省医药卫生科技计划项目(2016KYA041);浙江省自然科学基金(LY16H160037);国家自然科学基金(81672971)

通讯作者: 陈媛媛,Email:chenyy@zjcc.org.cn;陈明,Email:chenming@zjcc.org.cn

引用本文:

孙宗文,石磊,孔月等. 鼻咽癌IMRT海马头部、体部及尾部剂量分析[J]. 中华放射肿瘤学杂志, 2017, 26(11): 1253-1258.

Sun Zongwen,Shi Lei,Kong Yue et al. Preliminary results of the exposed dose of head,body and tail of the hippocampus in nasopharyngeal carcinoma patients treated with intensity modulated radiotherapy[J]. Chinese Journal of Radiation Oncology, 2017, 26(11): 1253-1258.

链接本文:

http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2017.11.003 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2017/V26/I11/1253

[1] Rosenthal DI,Chambers MS,Fuller CD,et al. Beam path toxicities to non-target structures during intensity-modulated radiation therapy for head and neck cancer[J].Int J Radiat Oncol Biol Phys,2008,72(3):747-755.DOI:10.1016/j.ijrobp.2008.01.012.
[2] Khodayari B,Michaud AL,Stanic S,et al. Evaluation of hippocampus dose for patients undergoing intensity-modulated radiotherapy for nasopharyngeal carcinoma[J].Br J Radiol,2014,87(1037):20130474.DOI:0.1259/bjr.20130474.
[3] Gondi V,Pugh SL,Tome WA,et al. Preservation of memory with conformal avoidance of the hippocampal neural stem-cell compartment during whole-brain radiotherapy for brain metastases (RTOG 0933):a phase Ⅱ multi-institutional trial[J].J Clin Oncol,2014,32(34):3810-3816.DOI:10.1200/JCO.2014.57.2909.
[4] Yakushev I,Müller MJ,Lorscheider M,et al. Increased hippocampal head diffusivity predicts impaired episodic memory performance in early Alzheimer′s disease[J].Neuropsychologia,2010,48(5):1447-1453.DOI:10.1016/j.neuropsychologia.2010.01.014.
[5] Greene SJ,Killiany RJ,Alzheimer′s Disease Neuroimaging Initiative. Hippocampal subregions are differentially affected in the progression to Alzheimer′s disease[J].Anat Rec (Hoboken),2012,295(1):132-140.DOI:10.1002/ar.21493.
[6] Gondi V,Tome WA,Rowley HA,et al. Hippocampal contouring:a contouring atlas for RTOG0933[R].https://www.rtog.org/CoreLab/ContouringAtlases/HippocampalSparing.aspx.
[7] Hackert VH,den Heijer T,Oudkerk M,et al. Hippocampal head size associated with verbal memory performance in nondemented elderly[J].NeuroImage,2002,17(3):1365-1372.DOI:10.1006/nimg.2002.1248.
[8] Sun XM,Su SF,Chen CY,et al. Long-term outcomes of intensity-modulated radiotherapy for 868 patients with nasopharyngeal carcinoma:An analysis of survival and treatment toxicities[J].Radiother Oncol,2014,110(3):398-403.DOI:10.1016/j.radonc.2013.10.020.
[9] Lee PW,Hung BK,Woo EK,et al. Effects of radiation therapy on neuropsychological functioning in patients with nasopharyngeal carcinoma[J].J Neurol Neurosurg Psychiatry,1989,52(4):488-492.DOI:10.1136/jnnp.52.4.488.
[10] Hsiao KY,Yeh SA,Chang CC,et al. Cognitive function before and after intensity-modulated radiation therapy in patients with nasopharyngeal carcinoma:a prospective study[J].Int J Radiat Oncol Biol Phys,2010,77(3):722-726.DOI:10.1016/j.ijrobp.2009.06.080.
[11] Scoville WB,Milner B.Loss of recent memory after bilateral hippocampal lesions[J].J Neurol Neurosurg Psychiatry,1957,20(1):11-21.DOI:10.1136/jnnp.20.1.11.
[12] Kesler S,Janelsins M,Koovakkattu D,et al. Reduced hippocampal volume and verbal memory performance associated with interleukin-6 and tumor necrosis factor-alpha levels in chemotherapy-treated breast cancer survivors[J].Brain Behav Immun,2013,30(Suppl):S109-S116.DOI:10.1016/j.bbi.2012.05.017.
[13] Mizumatsu S,Monje ML,Morhardt DR,et al. Extreme sensitivity of adult neurogenesis to low doses of X-irradiation[J].Cancer Res,2003,63(14):4021-4027.
[14] Raber J,Rola R,LeFevour A,et al. Radiation-induced cognitive impairments are associated with changes in indicators of hippocampal neurogenesis[J].Radiat Res,2004,162(1):39-47.DOI:10.1667/RR3206.
[15] Tomé WA,G khan ,Brodin NP,et al. A mouse model replicating hippocampal sparing cranial irradiation in humans:a tool for identifying new strategies to limit neurocognitive decline[J].Sci Rep,2015,5:14384.DOI:10.1038/srep14384.
[16] Gondi V,Hermann BP,Mehta MP,et al. Hippocampal dosimetry predicts neurocognitive function impairment after fractionated stereotactic radiotherapy for benign or low-grade adult brain tumors[J].Int J Radiat Oncol Biol Phys,2013,85(2):348-354.DOI:10.1016/j.ijrobp.2012.11.031.
[17] 中国鼻咽癌临床分期工作委员会.2010鼻咽癌调强放疗靶区及剂量设计指引专家共识[J].中华放射肿瘤学杂志,2011,20(4):267-269.DOI:10.3760/cma.j.issn.1004-4221.2011.04.001.Committee on Clinical Staging of Nasopharyngeal Carcinoma in China. Expert consensus on target area and dose design guidelines for 2010 nasopharyngeal carcinoma patients withradiotherapy[J].Chin J Radiat Oncol,2011,20(4):267-269.DOI:10.3760/cma.j.issn.1004-4221.2011.04.001.
[18] Sun Y,Yu XL,Luo W,et al. Recommendation for a contouring method and atlas of organs at risk in nasopharyngeal carcinoma patients receiving intensity-modulated radiotherapy[J].Radiother Oncol,2014,110(3):390-397.DOI:10.1016/j.radonc.2013.10.035.
[19] Lee NY,Zhang Q,Pfister DG,et al. Addition of bevacizumab to standard chemoradiation for locoregionally advanced nasopharyngeal carcinoma (RTOG 0615):a phase 2 multi-institutional trial[J].Lancet Oncol,2012,13(2):172-180.DOI:10.1016/S1470-2045(11)70303-5.
[20] 顾文栋,李齐林,田野,等.局部晚期鼻咽癌保护海马的IMRT计划对靶区及OAR剂量影响[J].中华放射肿瘤学杂志,2017,26(1):6-11.DOI:10.3760/cma.j.issn.1004-4221.2017.01.002.
Gu WD,Li QL,Tian Y,et al. Effects of hippocampal-sparing intensity-modulated radiotherapy on dose distribution of target volume and organs at risk in locally advanced nasopharyngeal carcinoma[J].Chin J Radiat Oncol,2017,26(1):6-11.DOI:10.3760/cma.j.issn.1004-4221.2017.01.002.
[21] Han G,Liu D,Gan H,et al. Evaluation of the dosimetric feasibility of hippocampal sparing intensity-modulated radiotherapy in patients with locally advanced nasopharyngeal carcinoma[J].PLoS One,2014,9(2):e90007.DOI:10.1371/journal.pone.0090007.
[22] Ouchi Y,Nobezawa S,Okada H,et al. Altered glucose metabolism in the hippocampal head in memory impairment[J].Neurology,1998,51(1):136-142.DOI:10.1212/WNL.51.1.136.
[23] Ariza M,Serra-Grabulosa J M,Junqué C,et al. Hippocampal head atrophy after traumatic brain injury[J].Neuropsychologia,2006,44(10):1956-1961.DOI:10.1016/j.neuropsychologia.2005.11.007.
[24] Daugherty AM,Yu QJ,Flinn R,et al. A reliable and valid method for manual demarcation of hippocampal head,body,and tail[J].Int J Dev Neurosci,2015,41:115-122.DOI:10.1016/j.ijdevneu.2015.02.001.