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目的 探讨鼻咽癌腔内照射计划个体化设计的意义和方法。方法 自１９９６年３月至１９９８年１１月，作者利用ＫＤＨ－３近距离治疗计划系统，个体化设计不同部位鼻咽癌灶腔内照射计划 １０５例次，本文将其分类，并通过比较“个体化计划”与“常规计划”参考体积大小、参考等剂量面包绕肿瘤情况、软腭最大受量和后鼻孔受量等参数，评价二者剂量分布的优劣。结果“常规计划”存在参考体积较大，软腭及后鼻孔受量较高，且参考等剂量面常不能完全包绕肿瘤等缺点。而“个体化计划”不但参考等剂量面可完全包绕肿瘤，且较“常规计划”参考体积小，软腭及后鼻孔受量低。结论鼻咽癌的腔内照射采用非个体化的“常规计划”剂量分布常不合理，有必要根据病变部位、范围及邻近重要结构进行个体化设计。
Objective To explore the significance and methods of individualized design of intracavitary irradiation for nasopharyngeal carcinoma. Methods From March 1996 to November 1998, the author used the KDH-3 brachytherapy system to design 105 cases of nasopharyngeal foci in different parts individually. This article classifies them and compares them by comparing “ The reference plan of the plan and the routine plan reference volume size, reference equal breadth of bread around the tumor, the largest amount of soft palate and after the nasal orifice and other parameters, evaluation of both the advantages and disadvantages of dose distribution. Results There was a large reference volume in the ”routine plan“, the soft palate and the posterior nostril were subject to higher doses, and the reference isosurface often could not completely surround the tumor. The ”individualized plan“ not only refers to the isodose side can completely surround the tumor, and ”regular plan“ reference volume is small, soft palate and posterior nasal hole by the amount of low. Conclusion It is unreasonable to use intracavitary irradiation of non-individualized ”regular plan" dose distribution for nasopharyngeal carcinoma. It is necessary to make individualized design according to lesion location, range and adjacent important structures.