接受輻射治療之鼻咽腫瘤患者其視綱膜病變之評估

Radiation Retinopathy Following Radiation Therapy in Nasopharyngeal Tumor Patients

張東杰(Tung-Chieh Chang) ； 林淵謙(luan-Chian Lin) ； 陳墩祿(Tun-Lu Chen) ； 楊克仁(Keh-Ren Yang) ； 陳麗惠(Li-Hui Chen) ； 湯國政(Simon Gou-Jeng Tang)

《放射治療與腫瘤學》 2卷3期 (1995/09) Pp. 203-208

https://doi.org/10.6316/TRO/199502(3)203

摘要

我們回顧15位鼻咽腫瘤，經眼底螢光攝影診斷有輻射視綱膜病變的病人，分析他們所接受的放射劑量及相關的危險因子。
自1984年至1992年共有15位病患（26隻眼睛）被診斷有輻射性視網膜病變。潛伏期從10個月至72個月，中問值是24個月，平均值為23個月。經分析計算後其所接受到的輻射劑量從2262cGy至5963cGy，中間值是3658cGy。平均值為3795cGy。有3位病人五隻眼睛除了視綱膜的血管病變外另有白內障的産生。於長期的追蹤期問，26隻眼睛中，視力有變化的有15隻眼睛，14隻眼睛有視網膜病變惡化的情況。五位接受化學治療的病人其劑量及潛伏期和其他病人並無顯著差異。有二位病人後來發現高血壓而接受內科治療。
我們在文中對輻射視網膜病變的輻射生物機轉做一可能探討幷回顧文獻。

關鍵字

輻射性視網膜病變 ； 鼻咽腫瘤 ； 放射綫治療

並列摘要

With retrospective methods, 15 patients of radiation retinopathy were diagnosed by fluores. cein angiography in ophthalmology department in those patients who received radiotherapy because of nasopharyngeal tumor. We analyze the retina irradiation dose and the relative risk factors.
Fifteen patients, 26 eyes of radiation retinopathy were found from 1984 to 1992.The median latent period was 20 months with the range of 10 to 72 months and the mean was 24 months. The median retina irradiation dose was 3688cGy ranging from 2262cGy to 5963cGy and the mean was 3795cGy after retrospective treatment plan computer analyses. Three patients, 5 eyes had cataract formation in addition to the radiation retinopathy. Visual acuity change in 15 eyes and progressive retinopathy in 14 eyes were found after long term follow-up. Five patients with additional chemotherapy showed no significant difference from other patients in term of the latent period anal irradiation dose for retinopathy. Hypertension was found in two patients who took the medication in the later follow-up period.
We discussed the possible mechanism in radiation biology and a review of the literature.

並列關鍵字

Radiation Retinopathy ； Nasopharyngeal tumor ； Radiotherapy