摘要
目的 分析接受根治性放疗的Ⅲ期非小细胞肺癌患者放射性肺炎（radiation pneumonitis, RP）发生相关的临床、剂量学因素。方法 回顾性分析北京大学肿瘤医院放疗科2013年1月至2014年12月收治的126例接受胸部根治性放疗的Ⅲ期非小细胞肺癌患者,统计性别、年龄、病理类型、肿瘤位置、糖尿病史、高血压病史、吸烟史、治疗开始季节、治疗前体力状况（采用美国东部肿瘤协作组ECOG评分）、放疗前化疗方案、同步化疗方案、放射性肺炎分级等临床因素,以及GTV体积、肺体积（lung volume, LV）、全肺V5、V10、V20、V30、平均肺剂量（MLD）等剂量学参数。对各因素与2级以上放射性肺炎（RP≥2）进行相关性分析。结果 126例患者中发生≥2级放射性肺炎者31例,占24.6%。单因素分析显示,年龄、治疗前ECOG评分、同步化疗方案、GTV/LV比值与≥2级RP具有相关性（R=0.157~0.222,P〈0.05）;多因素分析显示,年龄、同步化疗方案、GTV/LV比值与≥2级RP发生显著相关（Wald=4.754、6.422和14.79,P〈0.05）。结论 Ⅲ期非小细胞肺癌患者接受胸部根治性放疗时,年龄增加和GTV/LV比值≥3.2%是≥2级RP发生的危险因素;同步使用单药小剂量紫杉醇也可能导致放射性肺炎发生危险增加。
Objective To analyze relevant clinical and dosimetric factors associated with radiation pneumonitis in patients with stage Ⅲ non-small cell lung cancer after they received radical radiotherapy. Methods A total of 126 patients with stage Ⅲ non-small cell lung cancer who received precision radiotherapy in Peking University Cancer Hospital were analyzed from January 2013 to December 2014. Data were collected including various clinical factors （including sex, age, histological type, tumor location, history of diabetes, history of hypertension, history of smoking, the season patients received treatment, ECOG performance status before treatment, chemotherapy before radiotherapy, concurrent chemotherapy and the classification of radiation pneumonitis）, as well as related dosimetric parameters [including GTV, lung volume （LV）, bilateral V5, V10, V20, V30 and MLD]. SPSS 19.0 software was used to analyze the relation between correlation factors and radiation pneumonitis （RP≥2）. Results Among the patients, 31 cases （24.6%） had occurrance of radiation pneumonitis≥2. Univariate analysis showed that age, ECOG performance status before treatment, concurrent chemotherapy and GTV/LV ratio were significantly correlated with RP≥2 （R=0.157-0.222,P〈0.05）. Further multivariate Logistic regression showed that age, concurrent chemotherapy and GTV/LV ratio were significantly correlated（Wald=4.754,6.422,14.79,P〈0.05）. Conclusions In patients with stage Ⅲ non-small cell lung cancer after receiving thoracic radical radiotherapy, increasing age and GTV/LV ratio≥3.2% are risk factors of RP≥2. The concurrent chemotherapy with low-dose paclitaxel might also increase the risk of RP≥2.
出处
《中华放射医学与防护杂志》
CAS
CSCD
北大核心
2016年第4期272-277,共6页
Chinese Journal of Radiological Medicine and Protection
基金
北京市医院管理局临床医学发展专项，吴阶平医学基金会资助项目(WKJ055-3-006)Special Funding Support in Clinical Medicine Development of Beijing Municipal Administration of Hospitals，Wu Jieping Medical Foundation
关键词
非小细胞肺癌
放疗
放射性肺炎
大体肿瘤靶体积
肺体积
Non-small cell lung cancer
Radiotherapy
Radiation pneumonitis
Gross target volume
Lung volume
