| PARTI CLINICAL OUTCOMES AND FACTERS ANALYSIS OF CERVICAL LYMPH NODE RECURRENCE AFTER INTENSITY-MODULATED RADIATION THERAPY FOR NASOPHARYNGEAL CARCINOMA PATIENTSPurpose:To investigate the clinical features of cervical lymph node recurrence of nasopharyngeal carcinoma after intensity-modulated radiotherapy(IMRT).Methods:Retrospective analysis of 1335 cases of newly diagnosed nasopharyngeal carcinoma after radiotherapy in our hospital from January 1, 2007 to December 31,2014.27 cases with cervical lymph node recurrence according to the domestic staging standards in 2008,4 cases of stage II,13 cases of stage Ⅲ, and 10 cases of stagelV. N0, N1, N2 and N3 were 1,4, 17, and 5 cases, respectively. To analysis the cervical lymph node recurrence rate and the influence of nasopharyngeal carcinoma radiotherapy of cervical lymph node recurrence factors.Results:1335 cases of patients 1-,and 2-year regional local control rate was 96.0% and 94.7%,respectively. The cervical lymph node recurrence rate was 2.02%, N0, N1, N2, N3 recurrence rate was 1.11% and 1.07% and 2.03% and 2.86% respectively; The cervical lymph node recurrence rate of N2+N3(22/27) group is higher than N0+N1(5/27) group, It was showed that there was significant difference in cervical lymph node recurrence among different N stage, the single factor and multi factor analysis showed that the cervical lymph node recurrence and treatment of cervical lymph node N staging.Conclusion:Radiotherapy of cervical lymph node recurrence of nasopharyngeal carcinoma and N staging. The recurrence rate increases with the increase of N stage, and N stage is an important factor affecting the prognosis of nasopharyngeal carcinoma.PART Ⅱ COMPARATIVE ANALYSIS OF NASOPHARYNGEAL CARCINOMA SUSPICIOUS POSITIVE LYMPH NODE NECK IN THE DRAINAGE REGION BEFORE AFTER INTENSITY—MODULATED RADIOTHERAPYPurpose:Patients with nasopharyngeal carcinoma were treated with intensity modulated radiation therapy. The changes of suspicious positive lymph nodes in high-risk cervical lymph nodes draining area before radiotherapy and after radiotherapy were analyzed.Methods:Randomly selected from March 2015 to July 2015 in our hospital treatment of 10 cases of newly diagnosed nasopharyngeal carcinoma patients, All patients were treated with intensity modulated radiation therapy, and 3 patients with stage III patients combined with single agent cisplatin chemotherapy. After the end of radiotherapy review, in the thin layer CT analog positioning machine using the head and neck and shoulder thermoplastic mask fixed position and the same position of treatment before CT positioning for scanning review, To observe the changes of the suspicious positive lymph nodes in the drainage area of the high-risk lymph nodes in the neck.Results:The lymph nodes are examined by the same mask, the same position in the thin layer CT scanning before and after treatment, layer distance can be accurate to 2.5mm, the error of different cross sections of lymph nodes before and after is reducted a large degree compares with MRI.There were 18 suspicious positive lymph nodes in 10 patients,17 were significantly reduced after radiotherapy,1 was not changed, of which 14 were complete regressed,3 were partially regressed,1 was no changed. T test analysis of 18 suspicious positive lymph nodes with complete regression group and incomplete regression group. That PCTVndDmin and Dmax dose of incomplete regression group area small than the complete regression group, but the difference was not found in statistical significance.Conclusion:Cervical high risk for lymph node drainage area suspicious positive lymph node retraction may be related to the irradiation dose and high prevention dose for the retreat of suspicious positive lymph node may be increased, so that for the suspicious positive lymph node in the drainage area should be sketched out and given a high prevention dose in the high-risk drainage area, but need a larger sample size and randomized controlled studies further confirmed. |
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