摘要
目的评估肺癌调强放射治疗引起的肺功能早期变化;初步评估肺灌注指导肺癌放射治疗设野的意义。方法 30例肺癌患者根据治疗前肺灌注检查分为3组,各组在设野时均尽量避开血流灌注正常的肺部。配对t检验比较各组肺功能指标变化。后依据是否进行同步放化疗分为单纯放疗组和化放疗联合组,比较药物肺损伤的影响。结果治疗前双肺灌注正常组的肺活量(VC)和一口气一氧化碳弥散量(TLCO-SB)在治疗前后有显著变化,其余肺功能检查指标无显著变化。肺灌注受损组的肺功能各项指标在放疗前后均无显著变化。化放疗联合组较单纯放疗组TLCO-SB变化显著。结论肺灌注指导设野有利于减少肺部放射性损伤。调强放射治疗对肺部通气功能的损害早期主要表现在肺活量的改变上。同步放化疗可加重肺弥散功能的损伤。
Objective To assess early changes in pulmonary function of patients with lung cancer after intensity modulation radiation therapy（IMRT）.To perform a preliminary evaluation of the possibility of using pulmonary perfusion imaging to select the beam arrangement.Methods 30 lung cancer patients received the pulmonary perfusion imaging and PFTs（pulmonary function tests） before and after IMRT.Based on pre-IMRT pulmonary perfusion images,the patients were divided into 3 groups.pre-IMRT pulmonary perfusion images were used to guide the beam arrangement in IMRT planning.The results were analyzed with the matched t test.And then all patients were divided into 2 groups according to whether they were treated with concurrent chemoradiotherapy or not.The aim was to investigate the effects of medication on pulmonary function.Result There was significant difference in VC and TLCO-SB in the group that pre-PFTs were normal.Other indexes were not significantly different.All indexes of other two groups had no significant difference.There was significant difference in TLCO-SB in the group with concurrent chemoradiotherapy.Conclusion Using pulmonary perfusion images to guide the beam arrangement in IMRT planning is good for the decrease of radiation induced lung injury.The early pulmonary function injury of IMRT appears in vital capacity.Concurrent chemoradiotherapy can aggravate the injury of pulmonary diffusion function.
出处
《福建医科大学学报》
2011年第6期430-433,437,共5页
Journal of Fujian Medical University
基金
福建省自然科学基金(2008J0268)
关键词
肺通气
灌流
辐射性肺炎
肺肿瘤
血气分析
体层摄影术
X线计算机
pulmonary ventilation
perfusion
radiation pneumonitis
lung neoplasms
blood gas analysis
tomography
X-ray computer
