CAJ | 학술논문

目的：观察Ⅲ＋Ⅳ期非小细胞肺癌（ NSCLC ）采用三维适形调强放疗后放射性肺炎发生的相关因素。方法87例接受三维适形调强放疗的NSCLC患者，通过观察临床因素（性别、年龄、肿瘤部位、肺部分叶、病理类型、临床分期、KPS评分，剂量学指标：全肺、患肺、健肺V5、V10、V20、V30，平均肺剂量、大体肿瘤体积、计划靶体积、射野数目、处方剂量）与发生≥1～＜3级、≥3级放射性肺炎的关系，以及全肺V5、V10、V20、V30与大体肿瘤体积、计划靶体积的相关性，判断V5、V10是否为放射性肺炎的诱发因素。结果结果显示，患者性别、年龄、肿瘤部位、肺部分叶、病理类型、临床分期、KPS评分与患者放射性肺炎的发生无相关性（P＞0．05）。全肺 V5、V10、患肺 V5、V10、V30、健肺 V10、全肺 V20、V30、患肺V20、健肺 V5、V20、V30、大体肿瘤体积、计划靶体积、射野数目与患者≥1～＜3级放射性肺炎的发生显著相关（ P＜0．05）。全肺V5、V20、患肺V20、V30、健肺V5、V10、V20、平均肺剂量、大体肿瘤体积、全肺V30、健肺V30与患者≥3级放射性肺炎均的发生显著相关（P＜0．05）。全肺V5、V10与57例发生≥1～＜3级放射性肺炎患者的GTV、PTV 均呈正相关性（γ＝0．755、0．655、0．573、0．351，P＜0．01）。全肺V20、V30与29例发生≥3级放射性肺炎患者的GTV、PTV 均呈正相关（γ＝0．822、0．751、0．710、0．804，P＜0．01）。结论 V5、V10为三维适形调强放疗后≥1级放射性肺炎的诱发因素。
목적：관찰Ⅲ＋Ⅳ기비소세포폐암（ NSCLC ）채용삼유괄형조강방료후방사성폐염발생적상관인소。방법87례접수삼유괄형조강방료적NSCLC환자，통과관찰림상인소（성별、년령、종류부위、폐부분협、병리류형、림상분기、KPS평분，제량학지표：전폐、환폐、건폐V5、V10、V20、V30，평균폐제량、대체종류체적、계화파체적、사야수목、처방제량）여발생≥1～＜3급、≥3급방사성폐염적관계，이급전폐V5、V10、V20、V30여대체종류체적、계화파체적적상관성，판단V5、V10시부위방사성폐염적유발인소。결과결과현시，환자성별、년령、종류부위、폐부분협、병리류형、림상분기、KPS평분여환자방사성폐염적발생무상관성（P＞0．05）。전폐 V5、V10、환폐 V5、V10、V30、건폐 V10、전폐 V20、V30、환폐V20、건폐 V5、V20、V30、대체종류체적、계화파체적、사야수목여환자≥1～＜3급방사성폐염적발생현저상관（ P＜0．05）。전폐V5、V20、환폐V20、V30、건폐V5、V10、V20、평균폐제량、대체종류체적、전폐V30、건폐V30여환자≥3급방사성폐염균적발생현저상관（P＜0．05）。전폐V5、V10여57례발생≥1～＜3급방사성폐염환자적GTV、PTV 균정정상관성（γ＝0．755、0．655、0．573、0．351，P＜0．01）。전폐V20、V30여29례발생≥3급방사성폐염환자적GTV、PTV 균정정상관（γ＝0．822、0．751、0．710、0．804，P＜0．01）。결론 V5、V10위삼유괄형조강방료후≥1급방사성폐염적유발인소。
Objective To observe related factors of radiation-induced pneumonitis in non-small cell lung cancer patients treated with three-dimensional conformal intensity-modulated radiotherapy .Methods Clinical dosimetry indicators of 87 NSCLC patients treated with three-dimensional conformal intensity-modulated radiotherapy were observed .Relationship between clinical factors(gender,age,tumor location,part of the lung lobe,histological type,clinical stage,KPS score,dosimetry indicators: whole lung,lung with disease,lung V5,V10,V20,V30,mean lung dose,gross tumor volume,planning target volume,the field number,the prescription dose)and the occurrence of ≥1~<3,≥3-grade radioactive pneumonia,whole of lung V5,V10,V20,V30 and gross tumor volume,planning target volume to determine whether lung dose-volume V5 ,V10 was a predisposing factor of radiation pneu-monitis.Results Gender,age,tumor site,part of the lung lobe,pathological type,clinical stage,KPS score,and were not related with radiation pneumonitis .Correlation analysis of the radiation dose and radiation injury results showed that the other were differ -ent in addition to the mean lung dose ,prescription dose and the V 10 of the whole lung ,suffering from lung V 5 ,V10 ,planning target volume,the field number,prescription dose pneumonia in studies of ≥1~<3 level and ≥3 level of radiation pneumonitis (P<0.05 ).in Correlation analysis of whole lung V5,V10,V20,V30 and the GTV,PTV,the V5,V10 and the GTV,the PTV was a signifi-cant correlation when ≥1~<3 radioactive pneumonia occurs (γ=0.755、0.655、0.573、0.351,P<0.01),the V20,V30 and the GTV,PTV was a significant positive correlation when ≥3 radiation pneumonitis occurred (γ=0.822、0.751、0.710、0.804,P<0.01).Conclusion The results show that V5,V10 are predisposing factors of ≥1 grade radiation pneumonitis after three-dimen-sional conformal intensity modulated radiotherapy .