Clinical Value and Hematological Impact of Intensity-Modulated Radiotherapy(IMRT)in Nasopharyngeal Carcinoma Patients

LIN Kuikui; SHEN Bing; LIU Shunhua

doi:10.3969/j.issn.2097-7026.2026.01.0010

Abstract：Objective An analysis of the effects of IMRT on radiation precision and hematological parameters in nasopharyngeal carcinoma patients.Methods A total of 87 patients with nasopharyngeal carcinoma admitted from January 2024 to June 2025 were selected and randomly divided into a control group(44 cases)and an observation group(43 cases)by computer-generated random numbers.The control group received the basic IMRT plan without cone-beam CT(CBCT)image guidance,while the observation group received the IMRT plan combined with CBCT image guidance.The target dose coverage,incidence of bone marrow suppression,and changes in quality of life were compared between the two groups.Results The observation group achieved target D95 dose of 68.30±1.20 Gy,showing a 7％improvement in conformity index(0.91±0.03 vs 0.85±0.05,P<0.05).The proportion of irradiated fields with dose deviation>5％decreased by 71％(4.65％vs 15.91％).During treatment,the incidence of grade Ⅲ-Ⅳ bone marrow suppression(11.63％vs 31.82％)and radiation dermatitis(20.93％vs 45.45％)in the observation group was significantly lower than the control group(P<0.05).Additionally,the lowest white blood cell count remained at 3.20±0.40×10^9/L,which was 18.5％higher than the control group(P<0.05).Six months post-treatment,the swallowing function score in the observation group decreased by 23％compared to the control group(24.30±3.20 vs 27.00).Conclusion By enhancing target dose conformity and minimizing normal tissue irradiation,,Intensity-modulated radiotherapy(IMRT)significantly reduced the risks of hematological toxicity and radiation mucosal damage in nasopharyngeal carcinoma patients.The CBCT dynamic positioning technology plays a crucial clinical role in mitigating unplanned dose deviations.