摘要
目的:分析三维适形放射治疗胸部肿瘤患者发生急性放射性肺损伤的临床、物理和生物学因素,为预测急性放射性肺损伤,优化放疗计划提供参考。方法:对84例胸部肿瘤放疗后发生急性放射性肺损伤的患者进行单因素和多因素Logistic回归及相关分析。采用双抗体夹心ELISA法检测放疗前、后的血浆转化生长因子-β1(TGF-β1)水平;从剂量体积直方图上获取放射物理数据。结果:84例患者中发生急性放射性肺损伤19例,其中Ⅰ级8例,Ⅱ级5例,Ⅲ级5例,Ⅳ级1例,急性放射性肺损伤的发生率为22.62%(19/84);单因素Lo-gistic回归分析显示与急性放射性肺损伤相关的因素有放疗前的肺功能(基础肺功能)、肺V20、化疗和放疗后的血浆TGF-β1升高,P<0.05。结果显示,放疗后总体血浆TGF-β1水平低于放疗前的水平。多因素Logistic回归结果显示,急性放射性肺损伤的独立危险因素为肺V20和基础肺功能(OR值分别为3.094、3.945)。结论:三维适形放射治疗胸部肿瘤时肺的V20和基础肺功能可能是引起急性放射性肺损伤的主要因素。放疗后血浆TGF-β1水平升高还不能作为预测急性放射性肺损伤的指标。
OBJECTIVE： To investigate the relationship between dose volume, clinical state, transforming growth factor batal （TGF-β1） and acute post-irradiation lung injury in thorax tumor treated with three dimensional conformal radiotherapy （a-DCRT）, in order to predict the acute post-irradiation lung injury and optimize the radiotherapy regimen. METHODS： In 84 patients with acnte post-irradiation lung injury in thorax tumor treated with 3 DCRT, the clinical and dose-volume histograms （DVH） data were collected and their plasma TGF-β1 levels of pre-RT were tested and post-RT with ELISA. Logis tic regression was used to test their relativities. RESULTS： According to the RTOG criteria, acute post-irradiation lung injury was observed in 19 cases （22.62%）, with 8 in grade Ⅰ, 5 in grade Ⅱ, 5 in grade Ⅲ, 1 in grade Ⅳ. The foundation lung function, lung V20, chemothera py, increase of plasma TGF-β1 level of pre-RT and post-RT were sig nificantly correlated with acute pos〉irradiation injury （P〈0.05）. The levels of plasma TGF-β1 in post-RT were lower than those in pre〉RT. Multilogistic regression analysis showed that the foundation lung function （OR=3. 945） and lung V20 （OR= 3. 094） were the independent factors for acute radiation lung injury. CONCLUSIONS： The foundation lung function and lung V20 are significantly associated with the a cute post-irradiation lung injury in thorax tumor treated with 3-DCRT. These factors should be given special consideration when planning the treatment for thorax tumor. A trend of the increase of plasma TGF-β1 concentration is not consistent enough to predicting acute post irradiation lung injury.
出处
《中华肿瘤防治杂志》
CAS
2008年第17期1336-1338,共3页
Chinese Journal of Cancer Prevention and Treatment
关键词
肿瘤/放射疗法
辐射性肺炎/诊断
放射疗法
适形
转化生长因子
neoplasms/radiotherapy
radiation pneumonitis/diagnosis
radiotherapy, conforrnal
transforming growth tactor
