鼻腔鼻窦畸胎癌肉瘤的调强放射治疗.ppt
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1、Cancer Center, Wuhan Union Hospital Gang PENG,Treatment of sinonasal teratocarcinosarcoma using IMRT,Changsha August 20, 2010,Introduction Case Discussion,case,discussion,introduction,SNTCS,sino nasal terato carcino sarcoma, 80 cases reported,case,discussion,introduction,History,Vencent J. Hyams Dir
2、ector of the Otolaryngic Pathology branch of the Armed Forces Institute of Pathology,1968-1984,Teratoid carcinosarcoma ? Mixed mesodermal tumour ? Malignant teratoma and blastomas ?,1984,case,discussion,introduction,Characteristics,T1-weighted MR reveals a soft tissue filling the left ethmoid sinus,
3、 as uniformly high signal (*), and effusion (white arrowhead) in the left sphenoid sinus. Takasaki, K.,2006,Epithelial glandular carcinoma (at right) and osteosarcoma component (at left). (hematoxylin-eosin, original magnification x40). Smith, S. L.,2008,Endoscopic examination showing a left sinonas
4、al tumor in the left middle turbinate. M, middle turbinate; S, nasal septum. Su, Y. Y., 2010,Treatment,case,discussion,introduction,Patients generally present with locally advanced-stage disease the highly malignant, aggressive biological behavior the presence of air filled paranasal spaces permits
5、silent growth Distant metastasis of SNTCS is unusual and the most common cause of treatment failure is local recurrence Surgical excision and postoperative radiotherapy has become the most widely accepted therapeutic plan,Introduction Case Discussion,HPI,introduction,discussion,case,42-year-old man
6、Two weeks history of progressive left nasal obstruction and intermittent nasal bleeding Nasal examination showed a moderately firm, reddish-purple mass in the left meatus Biopsy of the tumor revealed a heterogeneous admixture of epithelial and mesenchymal elements, suggesting SNTCS,Teratocarcinosarc
7、oma Teratocarcinosarcoma consists of two components, epithelial and mesenchymal (hematoxylin-eosin, original magnification 200),cT3N0M0,MRI,introduction,discussion,case,MRI revealed a soft tissue filling the left meatus, maxillary and ethmoid sinus, and effusion in the left maxillary sinus,introduct
8、ion,discussion,case,Anterior craniofacial resection IMRT GTV included the residual gross disease in the nasal cavity and paranasal sinus CTV-60 includes the GTV with a 510 mm margin, the whole nasal cavity and the involved paranasal sinus CTV-54 high-risk local structures (including the whole nasoph
9、arynx, lower half of sphenoid sinus, et al) lymphatic regions (including ipsilateral lymph node levels IB, II, III and VA) A 3-mm margin was added to produce PTVs PTV-66 was prescribed to 66 Gy with 2.2 Gy/fraction PTV-60 was prescribed to 60 Gy with 2.0 Gy/fraction PTV-54 was prescribed to 54 Gy wi
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- 关 键 词:
- 鼻腔 鼻窦 畸胎癌 肉瘤 放射 治疗
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