医学理论与实践
醫學理論與實踐
의학이론여실천
The Journal of Medical Theory and Practice
2014年
23期
3092-3094,3099
,共4页
调强放射治疗%肺癌%放射性肺损伤%危险因素
調彊放射治療%肺癌%放射性肺損傷%危險因素
조강방사치료%폐암%방사성폐손상%위험인소
Intensity-modulated radiation therapy%Lung cancer%Lung injury%Risk factors
目的：探讨肺癌调强放疗后放射性肺损伤发生的危险因素。方法：选择我院放疗科收治的非小细胞肺癌患者190例。患者以调强放射治疗，部分患者联合化疗，对患者随访期间发生的放射性肺损伤的危险因素进行单因素和多因素分析。结果：本组190例患者，调强放疗后发生肺损伤40例，发生率为21．1％，肺损伤率随参数双侧肺M LD、患侧肺M LD、患侧肺V20的增加而增加（ P＜0．05）。G T V≥125cm2者肺损伤率明显高于G T V＜125cm2者（ P＜0.05）。双侧肺M LD与患侧肺M LD、患侧肺V20间有显著相关性（ P＝0．00）；患侧肺M LD与患侧肺V20间有明显相关性（ P＝0．00）。Logistic多因素分析显示，患侧肺MLD是放射性肺损伤独立危险因素（P＝0．00）。结论：全肺MLD、患肺MLD或患肺V20、GTV与放射性肺损伤有一定的关系，因此实施放疗计划前，应充分评估剂量体积参数，结合GTV等因素，以利于提高肿瘤控制率，减少肺损伤。
目的：探討肺癌調彊放療後放射性肺損傷髮生的危險因素。方法：選擇我院放療科收治的非小細胞肺癌患者190例。患者以調彊放射治療，部分患者聯閤化療，對患者隨訪期間髮生的放射性肺損傷的危險因素進行單因素和多因素分析。結果：本組190例患者，調彊放療後髮生肺損傷40例，髮生率為21．1％，肺損傷率隨參數雙側肺M LD、患側肺M LD、患側肺V20的增加而增加（ P＜0．05）。G T V≥125cm2者肺損傷率明顯高于G T V＜125cm2者（ P＜0.05）。雙側肺M LD與患側肺M LD、患側肺V20間有顯著相關性（ P＝0．00）；患側肺M LD與患側肺V20間有明顯相關性（ P＝0．00）。Logistic多因素分析顯示，患側肺MLD是放射性肺損傷獨立危險因素（P＝0．00）。結論：全肺MLD、患肺MLD或患肺V20、GTV與放射性肺損傷有一定的關繫，因此實施放療計劃前，應充分評估劑量體積參數，結閤GTV等因素，以利于提高腫瘤控製率，減少肺損傷。
목적：탐토폐암조강방료후방사성폐손상발생적위험인소。방법：선택아원방료과수치적비소세포폐암환자190례。환자이조강방사치료，부분환자연합화료，대환자수방기간발생적방사성폐손상적위험인소진행단인소화다인소분석。결과：본조190례환자，조강방료후발생폐손상40례，발생솔위21．1％，폐손상솔수삼수쌍측폐M LD、환측폐M LD、환측폐V20적증가이증가（ P＜0．05）。G T V≥125cm2자폐손상솔명현고우G T V＜125cm2자（ P＜0.05）。쌍측폐M LD여환측폐M LD、환측폐V20간유현저상관성（ P＝0．00）；환측폐M LD여환측폐V20간유명현상관성（ P＝0．00）。Logistic다인소분석현시，환측폐MLD시방사성폐손상독립위험인소（P＝0．00）。결론：전폐MLD、환폐MLD혹환폐V20、GTV여방사성폐손상유일정적관계，인차실시방료계화전，응충분평고제량체적삼수，결합GTV등인소，이리우제고종류공제솔，감소폐손상。
Objective :To explore the risk factors of radiation‐induced lung injury among lung cancer patients who were treated with intensity‐modulated radiotherapy(IMRT) .Methods:190 patients with non small cell lung cancer who was treated in radiotherapy department of our hospital .They were treated with IMRT ,some patients were treated with IM‐RT combined with chemotherapy ,risk factors of radiation‐induced lung injury during follow‐up did univariate and mult‐ivariate analysis .Results:Among 190 patients ,there were 40 cases who had occurred radiation‐induced lung injury ,the incidence rate was 21 .1% ,the lung injury rate increased with parameters ,such as MLD of bilateral lung ,MLD of af‐fected side lung ,V20 of affected side lung increasing (P<0 .05) .The lung injury rate of patients with GTV ≥ 125cm2 was significantly higher than that of GTV<125cm2 (P<0 .05) .There was significant correlation between MLD of bi‐lateral pulmonary and MLD of affected side pulmonary ,V20 of affected side pulmonary (P=0 .00);there was significant correlation between MLD of affected side pulmonary and V20 of affected side pulmonary (P=0 .00);Logistic multivari‐ate analysis showed that the MLD of affected side pulmonary was an independent risk factor of radiation‐induced lung injury(P=0 .00) .Conclusion:The MLD of all lung ,MLD of affected side pulmonary ,V20 of affected side pulmonary , GTV and radioactive lung injury has certain relation ,so before implementation of radiotherapy plan ,the dose volume parameters should be assessed ,GTV and other factors were combined with ,in order to improve tumor control rate ,re‐duce lung injury .
