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本文分析鼻咽癌放疗后脑损伤 2 9例。男性 2 2例 ,女性 7例。年龄 2 6～ 36岁 ,平均 4 5.1岁。放疗鼻咽部采用 6 0CO -γ线或 8MV -X线照射 ,以耳前野为主 ;颈部用 6 0CO -γ线切线和深部X线或电子线垂直照射 ,均常规分割照射。鼻咽部剂量首程为 6 7～ 85GY ,再程为 50～ 6 9GY ;上颈部剂量为 4 5～ 80GY ;脑损伤单侧 1 7例 ,双侧 1 2例 ,累及顶叶 1 7例。 1 6例脑损伤侧出现脑中动脉增粗不均影像。结果提示放射性脑坏死与继发于血管损伤有关外 ,还可能与颈部放疗有关。对于T1- 2期患者 ,建议其耳前野的上界放在颅底线上 1 .0cm左右 ,以减轻脑组织的晚期损伤。
This article analyzes 29 cases of nasopharyngeal carcinoma after radiotherapy. There were 22 males and 7 females. Age 26 ~ 36 years old, with an average of 4 5.1 years old. Radiotherapy nasopharyngeal using 6 0CO-γ line or 8MV-X-ray irradiation to the ear field; neck with 60CO-gamma line and deep X-ray or electron beam vertical irradiation, are routinely divided irradiation. Nasopharyngeal dose of the first course of 6 7 ~ 85GY, then the course of 50 ~ 69GY; upper neck dose of 45 ~ 80GY; one side of the brain injury in 17 cases, bilateral 12 cases involving parietal 17 cases . 16 cases of brain injury side of the uneven thickening of the middle cerebral artery imaging. The results suggest that radiation-induced brain injury and secondary to vascular injury, but also may be related to neck radiotherapy. For T1 - 2 patients, it is recommended that the upper boundary of the ear field on the skull base line on the about 1 .0cm, in order to reduce the late damage of brain tissue.