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Radiation therapy, the treatment of nasopharyngeal effect how?

Radiation therapy, the treatment of nasopharyngeal effect how?

(Summary description)2010-5-13Themajorityofnasopharyngealcarcinoma(NPC)forlowdifferentiationcancer,highradiationsensitivityoftheradiation,andtheprimarytumorandnecklymphdrainageareawillbeincludedintheradiationfield.Sincethe1940sfromChinalaunchedthenasopharyngealcarcinoma(NPC)anddeepX-rayradiotherapy,50tothe1960sandcarryoutthe60CoexternalirradiationandirradiationOnoinsteadofnasopharynxandneckjointOnoTeru,reducedtheresponsetoradiotherapyandimprovethesurvivalrate.Atpresent,themosteffectiveandmosteffectivemethodistouse60

Radiation therapy, the treatment of nasopharyngeal effect how?

(Summary description)2010-5-13Themajorityofnasopharyngealcarcinoma(NPC)forlowdifferentiationcancer,highradiationsensitivityoftheradiation,andtheprimarytumorandnecklymphdrainageareawillbeincludedintheradiationfield.Sincethe1940sfromChinalaunchedthenasopharyngealcarcinoma(NPC)anddeepX-rayradiotherapy,50tothe1960sandcarryoutthe60CoexternalirradiationandirradiationOnoinsteadofnasopharynxandneckjointOnoTeru,reducedtheresponsetoradiotherapyandimprovethesurvivalrate.Atpresent,themosteffectiveandmosteffectivemethodistouse60

Information

2010-5-13
      The majority of nasopharyngeal carcinoma (NPC) for low differentiation cancer, high radiation sensitivity of the radiation, and the primary tumor and neck lymph drainage area will be included in the radiation field. Since the 1940s from China launched the nasopharyngeal carcinoma (NPC) and deep X-ray radiotherapy, 50 to the 1960s and carry out the 60Co external irradiation and irradiation Ono instead of nasopharynx and neck joint Ono Teru, reduced the response to radiotherapy and improve the survival rate. At present, the most effective and most effective method is to use 60Co remote therapeutic machine.
    1 nasopharyngeal carcinoma radiotherapy indications and contraindications
(1) radical radiotherapy indications: systemic condition medium above; skull base without obvious bone destructive; 3 CT or MRI slices showed parapharyngeal no or only mild to moderate infiltration; cervical lymph node diameter less than 8cm activity has not yet reached supraclavicular fossa were;, no distant organ metastasis were.
(2) palliative radiotherapy indications: KS grade 60 points or more; (2) the headache severe nasopharyngeal above the amount of bleeding; (3) the individual distant metastasis or cervical lymph node metastases larger than 10cm by palliative radiation after such as general situation is improving symptoms and disappearance of distant metastases can control, can be changed for radical radiation therapy.
(3) radiotherapy contraindications: KS classification below 60 points; II are widely distant metastasis; (3) acute infection with the sick; 4 radioactive brain and spinal cord injury.
(4) radiotherapy after radiation therapy
Principle: the following are advised not to radiation therapy (1) with a target area (including nasopharynx and neck target area) after radiotherapy for recurrence time not full a year; radiation encephalopathy or radiation myelopathy after radiotherapy in 2; (3) of the nasopharynx target area with a total course of treatment should not be more than three courses, cervical target zone should not be more than two courses.
    2 radiation selection and exposure range
(1) irradiation field design: to design the radiation fields of the principle is "small and no leakage, the tumors involved to all parts included in the radiation field, but the normal tissue to radiation field especially sensitive to radiotherapy should be protected and nasopharyngeal primary lesions mainly with bilateral preauricular wild, if of nasal cavity and nasopharynx side clearance involvement, and according to the nose of the wild, orbital involvement can be added according to orbital Ueno or orbital ousted. Should pay attention to protect the eye with lead, do not cause the occurrence of radiation cataract. The radiation range of the neck depends on the lesion of the lymph nodes, and the non palpable and neck lymph nodes often do preventive irradiation on both sides of the upper cervical region. If there is cervical lymph node metastasis, in addition to the radiation of the metastatic lesions, the lower part of the drainage area often do preventive irradiation.
    3 radiation dose and time
(1) continuous radiation therapy: 5 times a week, each time 200cGY, the total amount of TD6000 ~ 7000cGY / 6 ~ 7 weeks.
(2) segmentation radiotherapy: the radiation treatment is generally divided into two sections, 5 times a week, each 200cGY, each section about 3.5 weeks, two between the rest four weeks, the total dose TD6500 ~ 7000cGY.
    4 after intracavitary radiotherapy
(1) indication:
Nasopharyngeal localized small lesions (tumor thickness less than 0.5cm) is located in the top wall of the anterior wall or wall;
Residual lesions after external irradiation or after surgical resection of nasopharyngeal carcinoma
(2) treatment methods: external irradiation plus intracavitary irradiation and external exposure 4500 ~ 6000cGY and external irradiation after 1 to 2 weeks and then plus intracavitary radiotherapy in 1 ~ 2 times, at intervals of 7 to 10 days, each dose were submucous 0.25cm dose, giving 1000 ~ 2000cGY / time.
    5 radiation reaction and back disease and its treatment
(1) complications of radiotherapy
The systemic reactions: including dizziness, fatigue, appetite loss, nausea and vomiting, mouth odor, taste insomnia or sleepiness. Individual patient blood change can occur, especially the decrease of white blood cells. Although the phenomenon of varying degrees but by symptomatic treatment generally can be overcome, the completion of radiation treatment necessary can be vitamin B1, vitamin B6, vitamin C, metoclopramide etc., such as white blood cell count decreased less than 3 x 109 childhood should be suspended for radiotherapy.
    Local reactions: including the skin and mucous membrane of the salivary glands of the reaction, the performance of the skin reaction for dry dermatitis or wet dermatitis. Can be topical 0.1% borneol talcum powder or lanolin matrix of anti-inflammatory ointment mucosa reaction and for the performance of the nasopharynx and oropharynx mucosa hyperemia, edema, exudation and secretions accumulate,. Using local gargle and lubrication anti-inflammatory agent, minority patients with parotid gland dose 2 Gy can produce parotid swelling for 2 to 3 days, and then gradually swelling. When irradiation 40gy, saliva secretion was significantly reduced, and oral mucosa secretion, mucosal hyperemia, xerostomia, into the dry food difficult. Therefore, parotid gland should be to avoid excessive exposure.
(2) radiotherapy back): mainly dysfunction of the temporomandibular joint and soft tissue atrophy fibrosis, radioactive caries and radioactive jaw bone osteomyelitis and radiation-induced encephalomyelopathy. In proper ways that there is no reversal, symptomatic treatment and support methods have some help, it is necessary to strictly avoid excessive irradiation of vital organs and tissues. Welcome to consult the teshin Health Hotline: 010-51571020

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