中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2012年
4期
326-329
,共4页
王谨%庄婷婷%何智纯%彭芳%马红莲%周琦超%张黎%何振宇%包勇%邓小武%陈明
王謹%莊婷婷%何智純%彭芳%馬紅蓮%週琦超%張黎%何振宇%包勇%鄧小武%陳明
왕근%장정정%하지순%팽방%마홍련%주기초%장려%하진우%포용%산소무%진명
肺肿瘤/放射疗法%放射疗法,三维适形%放射性肺炎%剂量体积直方图
肺腫瘤/放射療法%放射療法,三維適形%放射性肺炎%劑量體積直方圖
폐종류/방사요법%방사요법,삼유괄형%방사성폐염%제량체적직방도
Lung neoplasms/radiotherapy%Radiotherapy,three-dimensional conformal%Radiation pneumonitis%Dose volume histogram
目的 评价剂量体积直方图参数及临床因素对非细胞肺癌三维适形放疗同期化疗后急性重度放射性肺炎( SARP)的预测价值.方法 回顾分析2006-2010年行三维适形放疗同期化疗的非小细胞肺癌147例病例资料.对有无SARP的剂量学参数行成组t检验,对有差异的和临床因素行Logistic法多因素预测分析.用受试者工作特征(ROC)曲线分析各剂量学因素的预测价值,Pearson法分析剂量学数据间相关性并从剂量学参数中提取有代表性因子.结果 全组患者SARP发生率为9.5％.平均肺剂量(MLD)、V20、V30 V40、V50与SARP发生相关(x2=4.87～6.84,P=0.009～0.025).控制SARP发生率≤5％时的界值分别为MLD≤16.77 Gy,V20≤34.15％,V30≤23.62％,V40≤18.57％,V50≤13.02％,其敏感性、特异性、ROC曲线下面积分别为78.0％、48.1％、0.678,42.9％、82.0％、0.661,78.6％、52.9％、0.667,71.4％、61.7％、0.677,57.1％、67.7％、0.651.因子分析显示可考虑选取MLD、V20、V30中的1个或2个,V40、V50中的1个用于预测SARP.肿瘤位于右中下肺者SARP发生率高于其他部位(22.2％∶6.7％,x2=6.19,P =0.023).结论 MLD、V20、V30、V40、V50可用于放射性肺炎预测,但单个预测价值不佳,要多种参数联合使用.肿瘤位于右肺中下叶者放疗后发生SARP危险性较肿瘤位于其他部位者高.
目的 評價劑量體積直方圖參數及臨床因素對非細胞肺癌三維適形放療同期化療後急性重度放射性肺炎( SARP)的預測價值.方法 迴顧分析2006-2010年行三維適形放療同期化療的非小細胞肺癌147例病例資料.對有無SARP的劑量學參數行成組t檢驗,對有差異的和臨床因素行Logistic法多因素預測分析.用受試者工作特徵(ROC)麯線分析各劑量學因素的預測價值,Pearson法分析劑量學數據間相關性併從劑量學參數中提取有代錶性因子.結果 全組患者SARP髮生率為9.5％.平均肺劑量(MLD)、V20、V30 V40、V50與SARP髮生相關(x2=4.87～6.84,P=0.009～0.025).控製SARP髮生率≤5％時的界值分彆為MLD≤16.77 Gy,V20≤34.15％,V30≤23.62％,V40≤18.57％,V50≤13.02％,其敏感性、特異性、ROC麯線下麵積分彆為78.0％、48.1％、0.678,42.9％、82.0％、0.661,78.6％、52.9％、0.667,71.4％、61.7％、0.677,57.1％、67.7％、0.651.因子分析顯示可攷慮選取MLD、V20、V30中的1箇或2箇,V40、V50中的1箇用于預測SARP.腫瘤位于右中下肺者SARP髮生率高于其他部位(22.2％∶6.7％,x2=6.19,P =0.023).結論 MLD、V20、V30、V40、V50可用于放射性肺炎預測,但單箇預測價值不佳,要多種參數聯閤使用.腫瘤位于右肺中下葉者放療後髮生SARP危險性較腫瘤位于其他部位者高.
목적 평개제량체적직방도삼수급림상인소대비세포폐암삼유괄형방료동기화료후급성중도방사성폐염( SARP)적예측개치.방법 회고분석2006-2010년행삼유괄형방료동기화료적비소세포폐암147례병례자료.대유무SARP적제량학삼수행성조t검험,대유차이적화림상인소행Logistic법다인소예측분석.용수시자공작특정(ROC)곡선분석각제량학인소적예측개치,Pearson법분석제량학수거간상관성병종제량학삼수중제취유대표성인자.결과 전조환자SARP발생솔위9.5％.평균폐제량(MLD)、V20、V30 V40、V50여SARP발생상관(x2=4.87～6.84,P=0.009～0.025).공제SARP발생솔≤5％시적계치분별위MLD≤16.77 Gy,V20≤34.15％,V30≤23.62％,V40≤18.57％,V50≤13.02％,기민감성、특이성、ROC곡선하면적분별위78.0％、48.1％、0.678,42.9％、82.0％、0.661,78.6％、52.9％、0.667,71.4％、61.7％、0.677,57.1％、67.7％、0.651.인자분석현시가고필선취MLD、V20、V30중적1개혹2개,V40、V50중적1개용우예측SARP.종류위우우중하폐자SARP발생솔고우기타부위(22.2％∶6.7％,x2=6.19,P =0.023).결론 MLD、V20、V30、V40、V50가용우방사성폐염예측,단단개예측개치불가,요다충삼수연합사용.종류위우우폐중하협자방료후발생SARP위험성교종류위우기타부위자고.
Objective The study is to investigate the predictive values of dosimetric parameters and patient related factors in severe acute radiation pneumonitis (SARP) after concurrent chemoradiotherapy in non-small cell lung cancer (NSCLC).Methods In all,147 NSCLC patients treated with concurrent chemotherapy and 3DCRT between 2006 and 2010 was collected.Independent sample t test was used to compare parameter values between patients with SARP and those without SARP.Logistic regression was used to identify significant determined factor.Predictive value of each parameter was tested by ROC analysis.Pearson correlation was used to analyze correlations between parameters.Represent factors were identified by factor analysis.Results The incidence of SARP was 9.5％ ( 14/147 ).The means lung dose (MLD),V20,V30,V40,and V50 ( x2 =4.87 -6.84,P =0.009 -0.025,respectively ) were determining factors for SARP.Our datasets shows that for SARP ＜5％,MLD,V20,V30,V40 and V50 should be ≤16.77 Gy,V20≤34.15％,.V30 ≤23.62％,.V40 ≤ 18.57％,V50 ≤ 13.02％.ROC analysis show that areas under MLD,V20,V30,V40 and V50 curves was corresponding to 0.678,0.661,0.667,0.677,and 0.651,respectively.In addition,the sensitivity and specificity of each parameter at cutoff values are:78.0％ and 48.1％ for MLD;42.9％ and 82.0％ for V2o ;78.6％ and 52.9％ for V30 ;71.4％ and 61.7％ for V40,and 57.1％ and 67.7％ for V50.Factor analysis suggest that we can choose 1 or 2 parameters from MLD,V20,or V30,and another from V40 or V50 for predicting.The incidence of SARP was greater in patients with tumorsin right lower lung than other locations ( 22.2％ vs 6.7％,x2 =6.19,P =0.0 2 3 ).Conclusions The MLD,V20,V30,V40 and V50 are determining factors for SARP.As predictive value of each parameter alone is relatively week,using two or more parameters to predict SARP is recommended.
