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Kuang-Hsu Lien^1,2,3, Chien-Yu Lin^4,5,6, Po-Yuan Chen⁴

¹Department of Otolaryngology-Head & Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333423, Guishan District, Taiwan.

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

|January 8, 2026

概括

强度调节的质子疗法 (IMPT) 在鼻癌 (NPC) 患者中,与体积调节弧线疗法 (VMAT) 相比,显著降低了尾管的辐射剂量. 这导致听力结果改善和耳毒性降低,为NPC提供了更好的治疗选择.

科学领域:

辐射瘤学辐射瘤学
耳鼻喉科耳鼻喉科耳鼻喉科
医学物理医学物理

背景情况:

鼻癌 (NPC) 治疗往往涉及放射治疗,存在耳损伤和听力损失的风险.
强度调节的质子疗法 (IMPT) 和体积调节的弧线疗法 (VMAT) 是具有不同剂量分布配置的先进放射治疗技术.
将IMPT和VMAT之间的耳剂量和随后的听力结果进行比较对于优化NPC治疗策略至关重要.

研究的目的:

为了在NPC患者中比较IMPT和VMAT之间输送到尾管的辐射剂量.
评估和比较IMPT和VMAT治疗的患者之间的听力结果,包括听力测量评估.
确定IMPT在缓解耳毒性方面的潜力,与NPC患者的VMAT相比.

主要方法:

一项前性匹配队列研究,涉及180名新诊断的,未经治疗的NPC患者.
根据性别,年龄和疾病阶段,患者与1:1匹配,分为IMPT (n=90) 或VMAT (n=90) 组.
记录了耳平均剂量,并在治疗前和治疗后进行了听力学评估 (纯色音量计,空气骨间隙,词识别得分).

主要成果:

与VMAT相比,IMPT显著降低了与ipsilateral (47.51对56.82 Gy) 和contralateral (30.79对45.71 Gy) 的平均剂量.与VMAT相比,IMPT显著降低了与VMAT相比的ipsilateral (47.51对56.82 Gy) 和contralateral (30.79对45.71 Gy) 的平均剂量 (P<0.001对两者).
在12.1个月的中位随访期,IMPT患者显示出更好的平均纯色调听力测试值 (33.72比42.00dB,P=0.016) 和优异的高频听力 (37.94比53.82dB,P<.001).
与VMAT相比,IMPT还导致了较低的空气-骨间隔 (5.67 vs 10.62 dB,P < .001) 和较高的文字识别得分 (96.67% vs 94.00%,P = .039).

结论:

强度调节质子疗法 (IMPT) 明显降低了NPC患者的耳辐射剂量,相对于VMAT.
通过IMPT降低耳剂量,可以显著改善听力保存和功能.
在鼻癌患者中,IMPT显示了最大限度地减少辐射诱导的耳毒性.

关键词:

听力损失听力损失是什么强度调节的强度调节.鼻癌鼻癌鼻癌质子疗法是一种质子疗法.辐射疗法辐射疗法感应神经神经神经系统

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