中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2010年
1期
54-57
,共4页
张自成%徐瑾%李宝生%尹勇%黄勇%杨奉常%李洪升%孙洪福%陈进琥%刘波
張自成%徐瑾%李寶生%尹勇%黃勇%楊奉常%李洪升%孫洪福%陳進琥%劉波
장자성%서근%리보생%윤용%황용%양봉상%리홍승%손홍복%진진호%류파
肺癌%三维适形放射治疗%放射性肺损伤%CT分级
肺癌%三維適形放射治療%放射性肺損傷%CT分級
폐암%삼유괄형방사치료%방사성폐손상%CT분급
Lung cancer%Three-dimensional conformal radiotherapy%Radiation-induced lung injury%CT grade
目的 探讨接受三维适形放疗(3DCRT)后影响严重放射性肺损伤cT分级的危险因素.方法 回顾性分析89例3DCRT的肺癌患者临床资料和随访CT影像资料,统计各临床因素及剂量体积参数.观察放疗结束6-12个月的CT影像资料并根据CT影像资料对放射性肺损伤进行评定分级.分析≥3级严重放射性肺损伤的危险因素.统计采用SPSS 15.0软件.结果 89例患者放射性肺损伤CT分级情况:0级8例占9.O%,1级13例占14.6%,2级24例占27.0%,3级23例占25.8%.4级21例占23.6%.单因素分析显示同步化疗(CCT)、大体肿瘤体积(GTV)外放边界、患侧肺平均剂量、患侧肺的V_(15)-V_(45)差异有统计学意义.多因素Logistic回归分析显示:CCT、GTV外放边界和患侧肺V_(20)是影响严重放射性肺损伤CT分级的独立危险因素.结论 对接受3DCRT的肺癌患者,CCT、GTV外放边界和患侧肺V_(20)是影响严重放射性肺损伤CT分级的临床和剂量学危险因素.
目的 探討接受三維適形放療(3DCRT)後影響嚴重放射性肺損傷cT分級的危險因素.方法 迴顧性分析89例3DCRT的肺癌患者臨床資料和隨訪CT影像資料,統計各臨床因素及劑量體積參數.觀察放療結束6-12箇月的CT影像資料併根據CT影像資料對放射性肺損傷進行評定分級.分析≥3級嚴重放射性肺損傷的危險因素.統計採用SPSS 15.0軟件.結果 89例患者放射性肺損傷CT分級情況:0級8例佔9.O%,1級13例佔14.6%,2級24例佔27.0%,3級23例佔25.8%.4級21例佔23.6%.單因素分析顯示同步化療(CCT)、大體腫瘤體積(GTV)外放邊界、患側肺平均劑量、患側肺的V_(15)-V_(45)差異有統計學意義.多因素Logistic迴歸分析顯示:CCT、GTV外放邊界和患側肺V_(20)是影響嚴重放射性肺損傷CT分級的獨立危險因素.結論 對接受3DCRT的肺癌患者,CCT、GTV外放邊界和患側肺V_(20)是影響嚴重放射性肺損傷CT分級的臨床和劑量學危險因素.
목적 탐토접수삼유괄형방료(3DCRT)후영향엄중방사성폐손상cT분급적위험인소.방법 회고성분석89례3DCRT적폐암환자림상자료화수방CT영상자료,통계각림상인소급제량체적삼수.관찰방료결속6-12개월적CT영상자료병근거CT영상자료대방사성폐손상진행평정분급.분석≥3급엄중방사성폐손상적위험인소.통계채용SPSS 15.0연건.결과 89례환자방사성폐손상CT분급정황:0급8례점9.O%,1급13례점14.6%,2급24례점27.0%,3급23례점25.8%.4급21례점23.6%.단인소분석현시동보화료(CCT)、대체종류체적(GTV)외방변계、환측폐평균제량、환측폐적V_(15)-V_(45)차이유통계학의의.다인소Logistic회귀분석현시:CCT、GTV외방변계화환측폐V_(20)시영향엄중방사성폐손상CT분급적독립위험인소.결론 대접수3DCRT적폐암환자,CCT、GTV외방변계화환측폐V_(20)시영향엄중방사성폐손상CT분급적림상화제량학위험인소.
Objective To analyze the clinical and dosimetric risk factors for computed tomography (CT) grade of radiation-induced lung injury in lung cancer treated with three-dimensional conformal radiotherapy (3DCRT).Methods Eighty-nine lung cancer patients treated with 3DCRT were enrolled and CT scan images in more than 6 months were retrospectively analyzed.Clinical and dosimetric parameters were reviewed.Radiation-induced lung injuries were classified into 5 grades on CT images.Grade 3 or worse were considered clinically significant.Statistical software SPSS IS.0 was used to analyze the clinical and dosimetric risk factors that influenced the CT grade of radiation-induced lung injury.Results Eight of 89 patients (9.0%) developed grade 0 of radiation-induced lung injury,13 developed grade 1 (14.6%) ,24 developed grade 2 (27.0%) ,23 developed grade 3 (25.8%) and 21 developed grade 4 (23.6%).Univariable analysis showed that concurrent chemotherapy (CCT),GTV margin,involved ipsilateral lung mean lung dose(IMLD) ,the percent of involved ipsilateral lung receiving over IS,20,25 ,30,35 ,40 and 45 Gy (V_(15),V_(20) ,V_(25),V_(30) ,V_(35),V_(40) ,V_(45) were significantly associated with over grade 3 of radiation-induced lung injury .On multivariate logistic regression analysis,CCT,GTV margin and V_(20) of ipsilateral lung emerged as statistically significant risk factors of over grade 3 radiation-induced lung injuries CT images.Conclusions CCT,GTV margin and V_(20) of ipsilateral lung might be clinical and dosimetric risk factors associated with the severe CT grade of radiation-induced lung injury for lung cancer treated with 3DCRT.
