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目的:研究鼻咽癌放射治疗后对记忆力的影响,探索记忆力检测作为放射性脑损伤早期发现方法的可行性。方法:对61例鼻咽癌放射治疗后患者进行记忆商测定,20例同时做脑部CT和/或MRI检查。结果:全组61例鼻咽癌患者放射治疗后的记忆商很差和差者占18.0%(11/61),中下者29.5%(18/61),中等39.3%(24/61),中上8.2%(5/61),优秀3.3%(2/61),很优秀仅1.6%(1/61)。记忆商的等级与受照射剂量有密切的关系,记忆商差和很差者11例中9例照射剂量在70Gy以上。鼻咽部放射治疗后因复发行再程放射治疗8例中有6例(75.0%)记忆商<89分(属于中下至很差等级)。记忆商的等级与脑萎缩或脑软化程度有明显相关性,20例中记忆商89分以下者12例在脑CT或MRI显示均有明显脑萎缩改变,且8例发生脑软化(均为颞底部)。记忆商的等级与放射治疗后生存时间的延长无明显差异。结论:放射治疗后鼻咽癌患者记忆商下降与放射性脑损伤成正比,初步提示记忆力的动态测评可作为鼻咽癌放射治疗后脑损伤的一个观察指标。
Objective: To study the effect of radiation therapy on the memory of nasopharyngeal carcinoma and to explore the feasibility of detecting memory as an early detection method of radiation brain injury. Methods: 61 patients with nasopharyngeal carcinoma after radiotherapy patients were measured memory, 20 cases of simultaneous brain CT and / or MRI examination. Results: The poor memory and poor prognosis of 61 NPC patients after radiotherapy accounted for 18.0% (11/61), 29.5% (18/61), 39.3% (24/61), respectively In the upper 8.2% (5/61), outstanding 3.3% (2/61), very good only 1.6% (1/61). The level of memory business and irradiation dose are closely related to the memory poor and poor in 11 cases, 9 cases of radiation doses above 70Gy. Nasopharyngeal radiation therapy after recurrence due to radiation therapy in 8 cases, 6 cases (75.0%) memory providers <89 points (belonging to the poor to poor grades). There was a significant correlation between the level of memory and the degree of brain atrophy or brain softening. In the 20 cases, the score of 89 or less in the 20 cases showed obvious brain atrophy on brain CT or MRI, and 8 cases had brain softening bottom). There was no significant difference in memory class and survival time after radiotherapy. Conclusion: The decline of memory in nasopharyngeal carcinoma patients after radiotherapy is proportional to radiation brain injury, suggesting that the dynamic assessment of memory may serve as an observation index for brain injury after radiotherapy of nasopharyngeal carcinoma.