中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
Chinese Journal of Radiation Oncology
2015年
6期
605-610
,共6页
孙帅%王静波%吉喆%陈辛元%毕楠%周宗玫%冯勤付%惠周光%梁军%肖泽芬%吕纪马%王小震%张福泉%殷蔚伯%王绿化
孫帥%王靜波%吉喆%陳辛元%畢楠%週宗玫%馮勤付%惠週光%樑軍%肖澤芬%呂紀馬%王小震%張福泉%慇蔚伯%王綠化
손수%왕정파%길철%진신원%필남%주종매%풍근부%혜주광%량군%초택분%려기마%왕소진%장복천%은위백%왕녹화
癌,非小细胞肺/调强放射疗法%癌,非小细胞肺/化学疗法%急性症状性食管炎
癌,非小細胞肺/調彊放射療法%癌,非小細胞肺/化學療法%急性癥狀性食管炎
암,비소세포폐/조강방사요법%암,비소세포폐/화학요법%급성증상성식관염
Cacinoma,non-small cell lung/intensity modulated radiotherapy%Cacinoma,non-small cell lung/chemotherapy%Acute symptomatic esophagitis
目的：探索局部晚期NSCLC患者IMRT后急性症状性食管炎的发生率及相关预测因素。方法2007—2011年间在本院治疗的256例未手术的Ⅲ期NSCLC患者。放疗靶区包括原发肺肿瘤及受累淋巴引流区，中位剂量为60 Gy分30次（50～70 Gy）。109例（42．6％）接受同期化疗。放疗期间及放疗结束后3个月内出现≥2级急性食管炎（症状性食管炎）作为终点事件，采用CTCAE3．0评估急性食管炎级别。采用Logistic回归模型对预测因素进行分析。结果174例患者（68％）出现治疗相关的≥2级急性食管炎，其中154例（60．2％）为2级、20例（7．8％）为3级。≥2级急性食管炎发生时的中位剂量为30 Gy （11～68 Gy）。食管V5—V60、食管平均剂量及年龄是≥2级急性食管炎的预测因素（P＝0．021、0、0．010），其中高龄是保护性因素；食管V50—V60、同期化疗、体重指数是≥3级急性食管炎的预测因素（P＝0．010、0．003、0．019），其中高体重指数是保护性因素。结论局部晚期NSCLC患者IMRT后食管V50—V60和同期化疗是≥3级急性食管炎的预测因素，食管V50对预测≥2级、≥3级急性食管炎都有较高价值。
目的：探索跼部晚期NSCLC患者IMRT後急性癥狀性食管炎的髮生率及相關預測因素。方法2007—2011年間在本院治療的256例未手術的Ⅲ期NSCLC患者。放療靶區包括原髮肺腫瘤及受纍淋巴引流區，中位劑量為60 Gy分30次（50～70 Gy）。109例（42．6％）接受同期化療。放療期間及放療結束後3箇月內齣現≥2級急性食管炎（癥狀性食管炎）作為終點事件，採用CTCAE3．0評估急性食管炎級彆。採用Logistic迴歸模型對預測因素進行分析。結果174例患者（68％）齣現治療相關的≥2級急性食管炎，其中154例（60．2％）為2級、20例（7．8％）為3級。≥2級急性食管炎髮生時的中位劑量為30 Gy （11～68 Gy）。食管V5—V60、食管平均劑量及年齡是≥2級急性食管炎的預測因素（P＝0．021、0、0．010），其中高齡是保護性因素；食管V50—V60、同期化療、體重指數是≥3級急性食管炎的預測因素（P＝0．010、0．003、0．019），其中高體重指數是保護性因素。結論跼部晚期NSCLC患者IMRT後食管V50—V60和同期化療是≥3級急性食管炎的預測因素，食管V50對預測≥2級、≥3級急性食管炎都有較高價值。
목적：탐색국부만기NSCLC환자IMRT후급성증상성식관염적발생솔급상관예측인소。방법2007—2011년간재본원치료적256례미수술적Ⅲ기NSCLC환자。방료파구포괄원발폐종류급수루림파인류구，중위제량위60 Gy분30차（50～70 Gy）。109례（42．6％）접수동기화료。방료기간급방료결속후3개월내출현≥2급급성식관염（증상성식관염）작위종점사건，채용CTCAE3．0평고급성식관염급별。채용Logistic회귀모형대예측인소진행분석。결과174례환자（68％）출현치료상관적≥2급급성식관염，기중154례（60．2％）위2급、20례（7．8％）위3급。≥2급급성식관염발생시적중위제량위30 Gy （11～68 Gy）。식관V5—V60、식관평균제량급년령시≥2급급성식관염적예측인소（P＝0．021、0、0．010），기중고령시보호성인소；식관V50—V60、동기화료、체중지수시≥3급급성식관염적예측인소（P＝0．010、0．003、0．019），기중고체중지수시보호성인소。결론국부만기NSCLC환자IMRT후식관V50—V60화동기화료시≥3급급성식관염적예측인소，식관V50대예측≥2급、≥3급급성식관염도유교고개치。
Objective To explore the incidence and related predictive factors for acute symptomatic esophagitis in patients with locally advanced non?small cell lung cancer ( NSCLC ) treated with intensity?modulated radiation therapy ( IMRT) . Methods Data were collected retrospectively from 256 patients with inoperable or unresectable stage Ⅲ NSCLC treated in our hospital between January 2007 and December 2011. The radiotherapy target volume included primary lung cancer and lymphatic drainage area involved,with a median dose of 60 Gy in 30 fractions (50-70 Gy).Of all the patients,109 patients (42.6%) received concurrent chemotherapy. Grade ≥2 acute esophagitis ( AE ) ( symptomatic esophagitis ) which occurred during radiotherapy and within 3 months after completion of radiotherapy served as the outcome event. National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0( NCI?CTCAE3.0) was used to evaluate the grade of AE. The logistic regression model was used to analyze the predictive factors. Results A total of 174 patients ( 68%) had treatment?related grade ≥2 AE;154 patients ( 60. 2%) had grade 2 AE and 20 patients (7.8%) had grade 3 AE.The median dose when grade≥2 AE occurred was 30 Gy (11?68 Gy).For grade≥2 AE,multivariate analysis showed that esophageal V5?V60,mean dose,and age were independent predictive factors (P=0.021,0,0.010).For grade ≥3 AE,multivariate analysis showed that esophageal V50?V60 ,concurrent chemotherapy,and body mass index ( BMI) were independent predictive factors ( P= 0.010,0.003,0.019 ) . Old age and higher BMI were the protective factors for grade≥2 and ≥3 AE, respectively. Conclusions For patients with locally advanced NSCLC treated with IMRT, esophageal V50—V60 and concurrent chemotherapy are predictive factors for grade ≥3 AE,and esophageal V50 has a high predictive value for both grade ≥2 and ≥3 AE.
