鼻咽癌是常见肿瘤之一,广东、广西较多见,近年来北方也常见。由于解剖的原因头颈部是一个多变易动的部位,这就给放射治疗摆位带来许多困难,加上头颈部分很多重要器官如:脑干、脊髓和眼球等在照射野的附近,稍不注意或移动,就会造成靶区偏移,造成正常组织的损伤,最终导致治疗失败,现就鼻咽癌的放疗摆位技术体会如下: 1 耳前野、面颈联合野照射 1.1 取侧卧位,头垫枕,枕高与人肩相等,矢状面与床平行,病人双臂置体侧中线自然下垂,下肢稍弯曲,鼻尖与枕骨粗隆相连虚线与床面平行,注意保护眼睛。 1.2 取仰卧位,水平照射,病人头部放正,不可左右摆动,病人体位要自然、舒适。此种方法有利于摆位的重复性,建议多用这种摆位方法。 2 全颈切线照射 取仰卧位,双肩下垫枕或楔形枕,头部放正,头过仰,但后仰要适度,一般仰在照射野上缘垂直于床面为好,仰头过度会使小脑、脑干受量过高。分野照射时,机架角可向外给5～10度,避开脊髓,全颈照射时注意中间挡铅,保护脊髓、喉部、脑干。 3 颈部垂直照射野 取侧卧位,头下垫枕,头枕高等于肩高,头部中心线矢状面平行于床面,垂直机头,下颌稍内收,也可取仰卧位,水平照射。 4 讨论 耳前野、面颈联合野和颈部垂直野此三野最好采取仰卧位,头垫枕,因为身体容易保持稳定状态, Nasopharyngeal carcinoma is one of the common tumors, Guangdong and Guangxi are more common in the North in recent years. Due to the anatomy of the head and neck is a changeable site, which gives the placement of radiation therapy brings many difficulties, together with many important parts of the head and neck organs such as: brainstem, spinal cord and eyeball in the vicinity of the irradiation field, slightly Do not pay attention or move, it will cause the target area offset, resulting in damage to normal tissues, eventually leading to treatment failure, nasopharyngeal carcinoma radiotherapy positioning technology now experience as follows: 1 ear field, face and neck joint field irradiation 1.1 to take the lateral Position, head cushion pillow, pillow height equal to the shoulder, sagittal plane parallel to the bed, the patient’s midline prosthesis side of the natural sagging, lower limb slightly curved, nose and occipital trochanter connected with the dotted line parallel to the bed, pay attention to the protection of the eyes. 1.2 to supine, horizontal irradiation, the patient put the head positive, not swinging around, the patient position to be natural and comfortable. This method is conducive to the repeatability of positioning, it is recommended to use this method of positioning. 2 neck tangent irradiation supine position, shoulders under the pillow or wedge-shaped pillow, the head put positive, head over Yang, but the back should be moderate, generally Yang in the vertical edge of the irradiation field perpendicular to the bed as well, over-head will make Cerebellum, brain stem overdose. When the field of radiation, the rack angle can be outward to 5 to 10 degrees to avoid the spinal cord, the middle of the neck when the attention of the full range of lead burglar protection, the protection of the spinal cord, throat, brain stem. 3 vertical neck field to take wild lateral position, head pillow under the head, pillow high shoulder height, the center line of the sagittal plane parallel to the bed, vertical nose, mandibular adduction, but also supine, horizontal Irradiation. 4 discussions ear field, facial and neck joint field and neck vertical field The three wild is best to supine position, head cushion pillow, because the body easily maintain a stable state,