现代中西医结合杂志
現代中西醫結閤雜誌
현대중서의결합잡지
MODERN JOURNAL OF INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE
2014年
30期
3318-3320,3324
,共4页
李春璐%曲怡%杨月琴%陈英海%邹丽娟
李春璐%麯怡%楊月琴%陳英海%鄒麗娟
리춘로%곡이%양월금%진영해%추려연
乳腺癌根治术后放疗%放射性肺损伤%胸腺五肽
乳腺癌根治術後放療%放射性肺損傷%胸腺五肽
유선암근치술후방료%방사성폐손상%흉선오태
postoperative radiotherapy for breast cancer%radiation-induced lung injury%Thymopentin-5
目的：分析放射性肺损伤发生的相关因素，评价乳腺癌术后放疗联合胸腺五肽预防放射性肺损伤的临床疗效。方法回顾分析97例乳腺癌根治术后辅助性放疗患者的临床资料，包括年龄、化疗周期数、化疗药物、是否合并糖尿病及慢性阻塞性肺疾病（ COPD ）等；按治疗方法将患者分为2组，单纯放疗（RT）组32例，放疗联合胸腺五肽（RT＋TP-5）组65例，分析2组患者从放疗开始至放疗结束后4～16周的胸部CT影像学变化，比较2组放射性肺损伤的发病率以及相关的影响因素。结果 RT组放射性肺损伤发病率为44％，RT＋TP-5组放射性肺损伤发病率为34％，2组比较无显著性差异（ P＞0．05）。2组各年龄层发病率比较均无显著性差异（P均＞0．05）。行≤4周期化疗后放射性肺损伤发病率RT组为16％， TR＋TP-5组为23％，2组比较无显著性差异（P＞0．05）；行＞4周期化疗后放射性肺损伤发病率RT组为85％，TR＋TP-5组为47％，2组比较有显著性差异（ P＜0．05）。2组行≤4周期化疗后放射性肺损伤发病率与＞4周期比较均有显著性差异（ P均＜0．05）。是否合并糖尿病RT组放射性肺损伤发病率分别为45％和43％， TR＋TP-5组分别为39％和32％，2组比较均无显著性差异（ P均＞0．05）。结论乳腺癌根治术后行辅助放疗的患者全身化疗增加了放射性肺损伤的发病风险，且化疗周期越长，其发病风险越高。化疗方案、是否合并糖尿病与放射性肺损伤的发生无明显相关性。乳腺癌根治术后放疗同时应用TP-5可降低放射性肺损伤发生风险。
目的：分析放射性肺損傷髮生的相關因素，評價乳腺癌術後放療聯閤胸腺五肽預防放射性肺損傷的臨床療效。方法迴顧分析97例乳腺癌根治術後輔助性放療患者的臨床資料，包括年齡、化療週期數、化療藥物、是否閤併糖尿病及慢性阻塞性肺疾病（ COPD ）等；按治療方法將患者分為2組，單純放療（RT）組32例，放療聯閤胸腺五肽（RT＋TP-5）組65例，分析2組患者從放療開始至放療結束後4～16週的胸部CT影像學變化，比較2組放射性肺損傷的髮病率以及相關的影響因素。結果 RT組放射性肺損傷髮病率為44％，RT＋TP-5組放射性肺損傷髮病率為34％，2組比較無顯著性差異（ P＞0．05）。2組各年齡層髮病率比較均無顯著性差異（P均＞0．05）。行≤4週期化療後放射性肺損傷髮病率RT組為16％， TR＋TP-5組為23％，2組比較無顯著性差異（P＞0．05）；行＞4週期化療後放射性肺損傷髮病率RT組為85％，TR＋TP-5組為47％，2組比較有顯著性差異（ P＜0．05）。2組行≤4週期化療後放射性肺損傷髮病率與＞4週期比較均有顯著性差異（ P均＜0．05）。是否閤併糖尿病RT組放射性肺損傷髮病率分彆為45％和43％， TR＋TP-5組分彆為39％和32％，2組比較均無顯著性差異（ P均＞0．05）。結論乳腺癌根治術後行輔助放療的患者全身化療增加瞭放射性肺損傷的髮病風險，且化療週期越長，其髮病風險越高。化療方案、是否閤併糖尿病與放射性肺損傷的髮生無明顯相關性。乳腺癌根治術後放療同時應用TP-5可降低放射性肺損傷髮生風險。
목적：분석방사성폐손상발생적상관인소，평개유선암술후방료연합흉선오태예방방사성폐손상적림상료효。방법회고분석97례유선암근치술후보조성방료환자적림상자료，포괄년령、화료주기수、화료약물、시부합병당뇨병급만성조새성폐질병（ COPD ）등；안치료방법장환자분위2조，단순방료（RT）조32례，방료연합흉선오태（RT＋TP-5）조65례，분석2조환자종방료개시지방료결속후4～16주적흉부CT영상학변화，비교2조방사성폐손상적발병솔이급상관적영향인소。결과 RT조방사성폐손상발병솔위44％，RT＋TP-5조방사성폐손상발병솔위34％，2조비교무현저성차이（ P＞0．05）。2조각년령층발병솔비교균무현저성차이（P균＞0．05）。행≤4주기화료후방사성폐손상발병솔RT조위16％， TR＋TP-5조위23％，2조비교무현저성차이（P＞0．05）；행＞4주기화료후방사성폐손상발병솔RT조위85％，TR＋TP-5조위47％，2조비교유현저성차이（ P＜0．05）。2조행≤4주기화료후방사성폐손상발병솔여＞4주기비교균유현저성차이（ P균＜0．05）。시부합병당뇨병RT조방사성폐손상발병솔분별위45％화43％， TR＋TP-5조분별위39％화32％，2조비교균무현저성차이（ P균＞0．05）。결론유선암근치술후행보조방료적환자전신화료증가료방사성폐손상적발병풍험，차화료주기월장，기발병풍험월고。화료방안、시부합병당뇨병여방사성폐손상적발생무명현상관성。유선암근치술후방료동시응용TP-5가강저방사성폐손상발생풍험。
Objective It is to analyze the related factors of radiation-induced lung injury , and evaluate the clinical efficacy of postoperative radiotherapy for breast cancer combined with Thymopentin -5 on the prevention of radiation -induced lung in-jury.Methods The clinical data of 97 patients with postoperative radiotherapy for breast cancer were retrospective analyzed , including age , chemotherapy cycle , chemotherapeutics , with or with out diabetes , chronic obstructive pulmonary disease ( COPD) , etc.The patients were divided into 2 groups according to treatment methods , there were 32 cases in radiotherapy (RT) group, and 65 cases in radiotherapy combined with Thymopentin -5 (RT+TP-5) group.The image changes of two groups of patients CT from the beginning of the radiotherapy until 4 to 6 weeks after radiotherapy were analyzed .The morbidity and the relevant factors of two groups were compared .Results The morbidity was 44%in RT group and 34%in RT+TP-5 group, there was no significant difference between them (P>0.05).There were no significant differences between the onset of age level with two groups (P>0.05).For the group that have cycle of chemotherapy≤4, the rates of radiation-induced lung injury in RT group was 16%and 23% in TR+TP-5 group, there was no significant difference (P>0.05), For the group that have cycle of chemotherapy >4, the rates of radiation-induced lung injury in RT group was 85%and 47%in TR+TP-5 group, there was significant difference between them (P<0.05).There was no significant difference in the rates of ra-diation-induced lung injury between chemotherapy cycle in≤4 period and >4 period for both groups (all P<0.05).About whether with diabetes or not , the incidence of radiation -induced lung injury rates of RT group were 45%, 43%, while the rates of TR+TP-5 group were 39%, 32%, but there was no significant difference between both groups (P>0.05).Con-clusion For the patient with radiotherapy after radical operation of breast cancer , systemic chemotherapy can increased the risk of radiation-induced lung injury , and the chemotherapy cycle is longer , the risk of radiation-induced lung injury is higher . There are no significant correlation in chemotherapeutics , with or with out diabetes with radiation-induced lung injury .Postop-erative radiotherapy for breast cancer combined with TP -5 can decrease the risk of radiation-induced lung injury .
