摘要
目的探讨三维适形放射治疗(3D-CRT)非小细胞肺癌时,放射所致3～5级(RTOG标准)食管损伤的临床和剂量学相关因素。方法198例非小细胞肺癌患者予以三维适形放射治疗,对放射所致3～5级(RTOG标准)食管损伤的临床和剂量学相关因素进行分析,分析参数为:性别,年龄,一般状态,体重指数,序贯化疗,同期化疗,隆突下淋巴结,治疗前体重下降,整个食管平均剂量,最大剂量点,食管接受>50Gy的百分比。依据RTOG标准,分析早期和晚期3～5级食管损伤。结果198例中,24例(12.12%)发展为早期和晚期3～5级的食管损伤,其中7例包括早期和晚期损伤,1例死于食管穿孔。同期化疗和食管的最大剂量点≥50Gy与3～5级食管损伤明显有关(r=0.674,r=0.766,P<0.05)。其中同期化疗的55例(27.78%),23例(47.27%)有3～5级食管损伤。最大剂量点<50Gy的患者,3例有3～5级食管损伤(P<0.05)发生。结沦三维适形放射治疗(3D-CRT)非小细胞肺癌时,放射所致3～5级(RTOG标准)食管损伤与放化疗同期进行和最大剂量点≥50Gy明显相关。
[Objective] To explore the correlative clinical and dosimetric factors resulted in esophageal toxicity in the course of the treatment of the patients with non-small cell lung cancer with three-dimensional conformal radiotherapy（3D-CRT）. [Methods] One hundred and ninety-eight consecutive patients with NSCLC were treated with 3D-CRT. The correlative clinical and dosimetric factors were analyzed retrospectively resulted in esophageal toxicity in the course of the treatment. The clinical and dosimetric factors were studied basing on gender, age, performance status, weight index, sequential chemotherapy, concurrent chemotherapy, presence of carinal or subcarinal lymph nodes, weight loss in pre-treatment, mean dose to the entire esophagus, maximal point dose to the esophagus and percentage of volume of esophagus receiving〉50 Gy. Clinical and dosimetric factors were analyzed for radiation-induced acute and late grade 3～5 esophageal injury according to radiation therapy oncology group （RTOG） criteria. [Results] Twenty-four（12.12%） out of the 198 patients had developed acute or late grade 3～5 esophageal injury. 7 patients had both acute and late injury and 1 died of late esophageal perforation among them. Concurrent chemotherapy and maximal point dose to the esophagus ≥50 Gy were significantly associated with the esophageal injury （r =0.674, r =0.766,P 〈0.05）. Fifty-five（27.78%） out of the 198 patients had received concurrent chemotherapy, and 23（47.27%） patients out of the fifty-five had developed grade 3～5 esophageal injury（P 〈0.01）. 3 patients had suffered from grade 3～5 esophageal injury in the patients who received a maximal point dose to the esophagus〈50 Gy （P 〈0.05）. [Conclusion] Concurrent chemotherapy and the maximal esophageal point dose ≥50 Gy significantly related to the risk of grade 3～5 esophageal injury in patients with NSCLC treated with 3D-CRT.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2007年第15期1859-1862,共4页
China Journal of Modern Medicine
