中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2011年
1期
23-26
,共4页
韩蕾%卢冰%付和谊%胡银祥%甘家应%栗惠芹
韓蕾%盧冰%付和誼%鬍銀祥%甘傢應%慄惠芹
한뢰%로빙%부화의%호은상%감가응%률혜근
癌,非小细胞肺/同期放化疗法%放射疗法,三维适形%放射疗法,调强后程加速超分割%放射性肺炎
癌,非小細胞肺/同期放化療法%放射療法,三維適形%放射療法,調彊後程加速超分割%放射性肺炎
암,비소세포폐/동기방화요법%방사요법,삼유괄형%방사요법,조강후정가속초분할%방사성폐염
Carcinoma,non-small cell lung/concurrent radiochemotherapy%Radiotherapy,threedimensional conformal%Radiotherapy,intensity-modulated late-course accelered hyperfraction%Radiation paneumonitist
目的 探讨非小细胞肺癌化疗同期三维适形或调强放疗中位剂量70 Gy时临床因素与放射性肺炎(RP)的相关性.方法 采用三维适形或调强后程加速超分割放疗经病理或细胞学证实初治的非小细胞肺癌患者84例,同期化疗78例,化疗采用紫杉醇或多西紫杉醇或长春瑞滨+顺铂或卡铂一线方案.单因素分析病理类型、治疗方式、年龄、性别、临床分期、卡氏评分、吸烟、糖尿病、慢性阻塞性肺病(COPD)与RP相关性,对其中P＜0.10因素代入Logistic回归模型进行多因素分析.结果 84例患者中≥1级RP发生率为63%,≥2级为33%.单因素分析显示糖尿病与≥1级RP(x2=4.03,P=0.045)及≥2级RP相关(x2=15.59,P=0.000),卡氏评分与≥1级RP(x2=3.98,P=0.046)及≥2级RP相关(x2=5.21,P=0.023).多因素分析显示糖尿病与≥1级RP(x2=5.50,P=0.019)及≥2级(x2=12.92,P=0.000)RP发生相关,卡氏评分与≥1级RP(x2=6.29,P=0.012)及≥2级RP(x2=6.61,P=0.010)发生相关.结论 糖尿病、卡氏评分是非小细胞肺癌患者发生RP的危险因素,制定放疗计划时充分考虑可减少RP发生机会.
目的 探討非小細胞肺癌化療同期三維適形或調彊放療中位劑量70 Gy時臨床因素與放射性肺炎(RP)的相關性.方法 採用三維適形或調彊後程加速超分割放療經病理或細胞學證實初治的非小細胞肺癌患者84例,同期化療78例,化療採用紫杉醇或多西紫杉醇或長春瑞濱+順鉑或卡鉑一線方案.單因素分析病理類型、治療方式、年齡、性彆、臨床分期、卡氏評分、吸煙、糖尿病、慢性阻塞性肺病(COPD)與RP相關性,對其中P＜0.10因素代入Logistic迴歸模型進行多因素分析.結果 84例患者中≥1級RP髮生率為63%,≥2級為33%.單因素分析顯示糖尿病與≥1級RP(x2=4.03,P=0.045)及≥2級RP相關(x2=15.59,P=0.000),卡氏評分與≥1級RP(x2=3.98,P=0.046)及≥2級RP相關(x2=5.21,P=0.023).多因素分析顯示糖尿病與≥1級RP(x2=5.50,P=0.019)及≥2級(x2=12.92,P=0.000)RP髮生相關,卡氏評分與≥1級RP(x2=6.29,P=0.012)及≥2級RP(x2=6.61,P=0.010)髮生相關.結論 糖尿病、卡氏評分是非小細胞肺癌患者髮生RP的危險因素,製定放療計劃時充分攷慮可減少RP髮生機會.
목적 탐토비소세포폐암화료동기삼유괄형혹조강방료중위제량70 Gy시림상인소여방사성폐염(RP)적상관성.방법 채용삼유괄형혹조강후정가속초분할방료경병리혹세포학증실초치적비소세포폐암환자84례,동기화료78례,화료채용자삼순혹다서자삼순혹장춘서빈+순박혹잡박일선방안.단인소분석병리류형、치료방식、년령、성별、림상분기、잡씨평분、흡연、당뇨병、만성조새성폐병(COPD)여RP상관성,대기중P＜0.10인소대입Logistic회귀모형진행다인소분석.결과 84례환자중≥1급RP발생솔위63%,≥2급위33%.단인소분석현시당뇨병여≥1급RP(x2=4.03,P=0.045)급≥2급RP상관(x2=15.59,P=0.000),잡씨평분여≥1급RP(x2=3.98,P=0.046)급≥2급RP상관(x2=5.21,P=0.023).다인소분석현시당뇨병여≥1급RP(x2=5.50,P=0.019)급≥2급(x2=12.92,P=0.000)RP발생상관,잡씨평분여≥1급RP(x2=6.29,P=0.012)급≥2급RP(x2=6.61,P=0.010)발생상관.결론 당뇨병、잡씨평분시비소세포폐암환자발생RP적위험인소,제정방료계화시충분고필가감소RP발생궤회.
Objective To evaluate clinical factors as predictors of radiation pneumonitis(RP)in advanced stage non-small cell lung cancer(NSCLC)patients treated with concurrent radiochemotherapy when gross tumor volume is 70 Gy. Methods Data of 84 patients with histologically proved NSCLC treated with 3DCRT or IMRT were collected. To evaluate the correlation between clinical parameters and radiation pneumonitis(RP). The clinical parameters were considered: pathological type, therapy agents, age,gender, stage, karnofsky performance status(KPS), smoking status, diabetes, chronic obstructive pulmonary disease(COPD). Results The occurrence of grade 1,2 RP was 63%, 33%, respectively. In univariate analysis, diabetes was significantly associated with RP of ≥ grade 1(x2 =4.03, P = 0.045)and ≥grade 2(x2 = 15.59 ,P =0.000). KPS was significantly associated with RP of ≥grade 1(x2 =3.98 ,P = 0.046)and ≥grade 2(x2 = 5.21, P = 0.023). In logistic multivariate analysis, diabetes was significantly associated with RP of ≥grade 1(x2 =5.50,P =0.019)and ≥grade 2(x2 = 12.92,P =0.000). KPS was significantly associated with RP of ≥ grade 1(x2 = 6.29, P = 0.012)and ≥ grade 2(x2 = 6.61, P =0.010). Conclusion The definite statistical significant risk factors of RP are diabetes and KPS.
