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目的 :研究伽玛刀 (GK)治疗鼻咽癌的病理学变化。方法 :选取鼻咽癌放射治疗后肿瘤复发或残留患者15例 ,病理诊断为鳞状细胞癌 ,TNM分期为 T1～ 4N0 M0 ,给予 GK治疗 ,靶区包括在 5 0 %等剂量曲线之内 ,周边剂量为 2 0 Gy,治疗前及治疗后 1、3、6、12个月分别取鼻咽部癌组织进行病理学研究。结果 :1GK治疗后 1～ 3个月 ,癌组织内出现大量坏死细胞、急性炎症细胞浸润 ,组织出血 ;2 GK治疗后 6～ 12个月 ,病灶内有慢性炎症细胞浸润 ,纤维组织及毛细血管增生 ,未见肿瘤细胞。结论 :GK治疗鼻咽癌的近期病理学变化主要分两期 ,第 1期称坏死期 ,发生在 GK治疗后 1～ 3个月 ,第 2期为吸收期 ,发生在 GK治疗后 6～ 12个月。
Objective: To study the pathological changes of nasopharyngeal carcinoma treated with gamma knife (GK). Methods: Fifteen patients with recurrent or residual tumor after radiotherapy of nasopharyngeal carcinoma were selected. The pathological diagnosis was squamous cell carcinoma. The TNM stage was T1 ~ 4N0 M0. The target area was treated with GK. The target area was included in the isodose curve of 50% Peripheral dose of 20 Gy, before treatment and 1, 3, 6, 12 months after treatment were taken nasopharyngeal carcinoma pathological study. Results: 1 ~ 3 months after 1GK treatment, a large number of necrotic cells, acute inflammatory cell infiltration and tissue hemorrhage were found in the cancerous tissues. After 6 ~ 12 months of GK treatment, there were chronic inflammatory cell infiltration, fibrous tissue and capillaries Hyperplasia, no tumor cells. Conclusion: The recent pathological changes of nasopharyngeal carcinoma treated with GK are mainly divided into two phases, the first one is called necrosis, one to three months after GK treatment, and the second one is absorption phase, which takes place 6 ~ 12 after GK treatment Months.