国际肿瘤学杂志

国际肿瘤学杂志››2012,Vol. 39››Issue (6): 472-476.

• 论著 •上一篇下一篇

调强适形放疗对鼻咽癌患者眼部组织损伤的临床研究

李雁杰,刘海燕,王艳艳,王丽聪,赵长青

  1. 太原，山西医科大学第一医院眼科（李雁杰、王丽聪）,核医学科 （刘海燕）；山西省肿瘤医院CT/MRI室（王艳艳）；山西医科大学第二医院耳鼻咽喉头颈外科（赵长青）
  • 出版日期:2012-06-08发布日期:2012-06-25
  • 通讯作者:赵长青，E-mail: fahyj@126.com E-mail:fahyj@126.com

Clinical study of ocular damnification after intensity-modulated radiotherapy in patients with nasopharyngeal carcinoma

LI Yan-Jie,LIU Hai-yan, WANG Yan-yan, WANG Li-cong, ZHAO Chang-qing.

  1. *Department of Ophthalmology, First Hospital of Shanxi Medical University, Taiyuan 030001, China
  • Online:2012-06-08Published:2012-06-25
  • Contact:ZHAO Chang-qing, E-mail: fahyj@126.com E-mail:fahyj@126.com

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1759

被引次数

6

摘要：目的 研究调强适形放疗（IMRT）对鼻咽癌患者眼部正常组织的影响.方法 选取经病理证实的首程放疗鼻咽癌患者19例(38眼）。于IMRT前、放疗结束、放疗后6个月及12个月行视力、裂隙灯、眼底及图形视觉诱发电位（VEP）和视网膜电图（ERG）检查. 结果 ①患者放疗前后各检查时间点平均裸眼及矫正视力变化差异无统计学意义（P＞0.05）。 ②放疗前、放疗结束、放疗后6个月及放疗后12个月VEP P100波平均峰时分别为(99.684±2.484) μV 、(99.947±2.277) μV、(104.000±3.952) μV、(101.316±2.462) μV，放疗后6个月VEP P100波平均峰时较放疗前、放疗结束及放疗后12个月明显后延（P＜0.05）。③放疗前、放疗结束、放疗后6个月及放疗后12个月ERG b波平均峰时分别为(44.974±3.774) ms、(44.816±3.368) ms、(43.184±2.837) ms、(44.000±3.154) ms。放疗前、放疗结束、放疗后6个月及放疗后12个月ERG b波平均振幅分别为(421.237±27.353) μV、(414.763±26.188) μV、(419.026±24.876) μV、(419.974±25.894) μV。放疗前后各时间点ERG b波平均峰时、振幅变化均无统计学意义（P＞0.05）。④放疗前、放疗结束、放疗后6个月及放疗后12个月ERG Op2波平均振幅分别为(63.184±6.028) μV、 (48.605±6.872) μV、(50.421±6.769) μV、(53.026±6.074) μV。放疗后各检查时点与放疗前相比，ERG Op2波平均振幅均明显降低，差异有统计学意义（P＜0.05）。结论 IMRT能明显减少鼻咽癌患者眼部并发症的发生。ERG、VEP在检查IMRT对视网膜、视神经功能影响方面有较好的应用价值。

关键词:放射疗法,调强适形,鼻咽肿瘤,眼部并发症

Abstract:Objective To study the effect on normal ocular tissues after intensity-modulated radiotherapy (IMRT) in the patients with nasopharyngeal carcinoma. Methods Nineteen nasopharyngeal carcinoma patients confirmed by pathology were enrolled (38 eyes). All Patients underwent visual acuity, slit lamp, fundus, visual evoked potential (VEP) and electroretinograms (ERG) examination before IMRT, at the end of IMRT, 6 months and 12 months after IMRT. Results ① There was no statistically difference in uncorrected and corrected visual acuity at the various examination time points before and after radiotherapy (P＞0.05). ② Theaverage latency of VEP P100before IMRT,at the end of IMRT, at 6 months after IMRT and 12 months after IMRT was (99.684±2.484) μV , (99.947±2.277) μV, (104.000±3.952) μV and (101.316±2.462) μV respectively. The average latency of VEP P100was significantly prolonged at 6 months after IMRT compared with the time points of before IMRT, the end of IMRT and 12 months after IMRT (P＜0.05). ③ The average latency of ERG b wave before IMRT , at the end of IMRT, at 6 months after IMRT and 12 months after IMRT was (44.974±3.774) ms, (44.816±3.368) ms, (43.184±2.837) ms and (44.000±3.154) ms respectively。The average amplitude of ERG b wave before IMRT, at the end of IMRT, at 6 months after IMRT and 12 months after IMRT was (421.237±27.353) μV, (414.763±26.188) μV, (419.026±24.876) μV, and (419.974±25.894) μV respectively. No statistically difference was found in average latency and amplitude of ERG b wave at the various examination time points before and after radiotherapy (P＞0.05). ④ The average amplitude of Op2 wave before IMRT, at the end of IMRT, at 6 months after IMRT and 12 months after IMRT was (63.184±6.028) μV, (48.605±6.872) μV, (50.421±6.769) μV and (53.026±6.074) μV respectively. At the various time points after IMRT, the average amplitude of Op2 wave was significantly lower than before IMRT (P＜0.05).Conclusion IMRT can significantly reduce the incidence of ocular complications. There is a good clinical application value of ERG and VEP for evaluating retina and optical nerve functional changes induced by IMRT. 

Key words:Radiotherapy, intensity-modulated,Nasopharyngeal neoplasms,Ocular complications