肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2013年
1期
38-40
,共3页
耿冲%张旭光%陈宏林%杜傲男%沈曼曼
耿遲%張旭光%陳宏林%杜傲男%瀋曼曼
경충%장욱광%진굉림%두오남%침만만
胸部肿瘤%肺靶区%纵隔靶区%辐射性肺炎%放射疗法,适形
胸部腫瘤%肺靶區%縱隔靶區%輻射性肺炎%放射療法,適形
흉부종류%폐파구%종격파구%복사성폐염%방사요법,괄형
Thoracic neoplasms%Lung target%Mediastinal target%Radiation pneumonitis%Radiotherapy,conformal
目的 对肺癌(肺靶区)与纵隔肿瘤及食管癌(纵隔靶区)三维适形放疗中放射性肺炎(RP)发生的影响因素及剂量体积直方图(DVH)参数进行对比研究.方法 回顾性分析接受放射治疗的肺癌、纵隔肿瘤及食管癌患者83例的临床资料,采用x 2检验对临床因素(性别、年龄、肿瘤部位、分期、化疗)与RP发生的相关性进行分析；分别对两靶区的DVH参数与RP的发生进行相关性分析；用t检验对肺靶区与纵隔靶区DVH参数进行比较.结果 ≥2级RP发生率为36.5％(31/81).各临床因素与≥2级RP发生无关(x2值分别为0.377、0.215、0.018、0.717、0.215,均P＞0.05).两靶区的DVH参数中,V5、V10、V20、V30、全肺平均剂量(MLD)与RP的发生均具有明显相关性.两靶区发生RP的患者V5[(50.9±17.8)％、(69.9±20.4)％](t=2.745,P＜0.05)、V10[(38.6±15.2)％、(53.5±18.8)％](t=2.434,P＜0.05)差异均有统计学意义,而V20(t=0.388,P＞0.05)、V30(t=0.005,P＞ 0.05)及MLD(t=0.138,P＞0.05)差异均无统计学意义.两靶区未发生RP患者的DVH参数t检验后得到类似结果.结论 在肺靶区、纵隔靶区的放疗中,RP的发生与DVH参数密切相关,尤其是V20、V30及MLD对RP的发生有重要的影响.
目的 對肺癌(肺靶區)與縱隔腫瘤及食管癌(縱隔靶區)三維適形放療中放射性肺炎(RP)髮生的影響因素及劑量體積直方圖(DVH)參數進行對比研究.方法 迴顧性分析接受放射治療的肺癌、縱隔腫瘤及食管癌患者83例的臨床資料,採用x 2檢驗對臨床因素(性彆、年齡、腫瘤部位、分期、化療)與RP髮生的相關性進行分析；分彆對兩靶區的DVH參數與RP的髮生進行相關性分析；用t檢驗對肺靶區與縱隔靶區DVH參數進行比較.結果 ≥2級RP髮生率為36.5％(31/81).各臨床因素與≥2級RP髮生無關(x2值分彆為0.377、0.215、0.018、0.717、0.215,均P＞0.05).兩靶區的DVH參數中,V5、V10、V20、V30、全肺平均劑量(MLD)與RP的髮生均具有明顯相關性.兩靶區髮生RP的患者V5[(50.9±17.8)％、(69.9±20.4)％](t=2.745,P＜0.05)、V10[(38.6±15.2)％、(53.5±18.8)％](t=2.434,P＜0.05)差異均有統計學意義,而V20(t=0.388,P＞0.05)、V30(t=0.005,P＞ 0.05)及MLD(t=0.138,P＞0.05)差異均無統計學意義.兩靶區未髮生RP患者的DVH參數t檢驗後得到類似結果.結論 在肺靶區、縱隔靶區的放療中,RP的髮生與DVH參數密切相關,尤其是V20、V30及MLD對RP的髮生有重要的影響.
목적 대폐암(폐파구)여종격종류급식관암(종격파구)삼유괄형방료중방사성폐염(RP)발생적영향인소급제량체적직방도(DVH)삼수진행대비연구.방법 회고성분석접수방사치료적폐암、종격종류급식관암환자83례적림상자료,채용x 2검험대림상인소(성별、년령、종류부위、분기、화료)여RP발생적상관성진행분석；분별대량파구적DVH삼수여RP적발생진행상관성분석；용t검험대폐파구여종격파구DVH삼수진행비교.결과 ≥2급RP발생솔위36.5％(31/81).각림상인소여≥2급RP발생무관(x2치분별위0.377、0.215、0.018、0.717、0.215,균P＞0.05).량파구적DVH삼수중,V5、V10、V20、V30、전폐평균제량(MLD)여RP적발생균구유명현상관성.량파구발생RP적환자V5[(50.9±17.8)％、(69.9±20.4)％](t=2.745,P＜0.05)、V10[(38.6±15.2)％、(53.5±18.8)％](t=2.434,P＜0.05)차이균유통계학의의,이V20(t=0.388,P＞0.05)、V30(t=0.005,P＞ 0.05)급MLD(t=0.138,P＞0.05)차이균무통계학의의.량파구미발생RP환자적DVH삼수t검험후득도유사결과.결론 재폐파구、종격파구적방료중,RP적발생여DVH삼수밀절상관,우기시V20、V30급MLD대RP적발생유중요적영향.
Objective A comparative study of clinical factors and dose-volume histogram (DVH)parameters on the impact of radiation pneumonitis occurred in the three-dimensional conformal radiotherapy of lung cancer (lung target)and mediastinal tumors and esophageal (mediastinal target).Methods Review 83cases lung cancer,mediastinal tumors and esophageal patients,and analyzed with chi-square tests on the correlation of the clinical factors (gender,age,tumor location,stage,chemotherapy) with radiation pneumonitis;have relevance analysis between the DVH parameters of two targets and radiation pneumonitis; lung target and mediastinal target volume DVH parameters compared to the t-test.Results ≥2 radiation pneumonitis was 36.5 ％.≥2 radiation pneumonitis occurred in various clinical factors had no significant effect.DVH parameters of the two targets,V5,V10,V20,V30,whole lung dose (MLD) were significantly related to RP.Two targets of RP patients V5 [(50.9±17.8) ％,(69.9±20.4) ％],V10 [(38.6±15.2) ％,(53.5±18.8) ％] were statistically significant by t-test (t =2.434,P ＜ 0.05),while V20 (t =0.388,P ＞ 0.05),V30 (t =0.005,P ＞ 0.05) and MLD (t =0.138,P ＞0.05) were no significant difference (P ＞ 0.05),so the same results with the two targets of patients without RP obtained.Conclusion In the lung target and mediastinal target of radiotherapy radiation pneumonitis is related with DVH parameters,especially V20,V30 and MLD impact on the occurrence of RP.
