摘要
目的：研究食管癌根治性术后预防性IMRT后急性放射性胃炎发生与胸腔胃受量关系。方法对接受根治性术的49例食管癌患者术后预防性IMRT的治疗计划及患者治疗期间的急性放射性胃炎发生的情况进行分析。 ROC曲线分析与急性放射性胃炎发生可能相关的物理学指标，组间比较行χ2检验，Logistic法多因素分析。结果全组共19例（39％）患者出现≥2级急性急性放射性胃炎。 ROC曲线分析结果显示与急性放射性胃炎发生相关的物理变量包括胃Dmax、胃Dmean、LSTT5—LSTT40及V10—V50；依据ROC曲线所得各物理指标分界值对患者进行分组，除V5之外，余指标分界值以上组患者≥2级急性急性放射性胃炎发生率明显高于分界值以下组患者，各物理指标的组间差异均有统计学意义（ P＝0．000～0.022）。多因素分析结果显示LSTT5和V40为预测≥2级急性放射性胃炎发生的指标（ P＝0.026、0.001）。结论在制定食管癌术后患者预防性IMRT的治疗计划时应注意保护胸腔胃，DVH可以很好预测急性放射性胃炎发生，其中胃LSTT5及V40为预测指标。但最终有待于增加样本量进一步研究。
Objective To study the relationship between radiation gastritis （ RG ） caused by esophageal cancer radical postoperative prophylactic IMRT and the dose of gastric. Methods A total of 49 esophageal cancer patients received postoperative adjuvant radiatherapy after esophagectomy, we analysised the dose？volume histogram of treatment plan and the the occurrence of RG, To analysis those physical indicators may be related to the occurrence of RG. The of ROC curve to analysis the physical index of the occurrence of acute radiation gastritis, Chi square test is compared between groups, Logistic method was used to multivariate analysis. Results The whole group, a total of 19 cases （ 39%） patients with symptoms of acute RG level 2 or higher. The results of ROC curve analysis showed that the physical variables associated with the occurrence of RG include stomach Max,stomach Mean,LSTT5？LSTT40 and V5？V50.According to the ROC curve,the cutoff values of the physical parameters of the patients were grouped. The incidence of acute≥2RG in the group of above boundary value patients significantly higher than below boundary value group, the physical index of the differences between groups were significant （P=0. 000？0. 022）,except V5.The results of Logistic multivariate analysis showed that LSTT5 and V40 were independent predictor of≥2 RG （P=0. 026,0. 001）. Conclusions According to the results of this study,We should pay attention to the protection of the stomach in develop a treatment plan for the prevention of postoperative patients with esophageal cancer,dose？volume histogram can well predict the occurrence of RG. Stomach LSTT5 and V40 were independent predictor of≥2 RG.The results of this study need to be further studied.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2016年第8期818-822,共5页
Chinese Journal of Radiation Oncology
关键词
食管肿瘤/术后放射疗法
放射性胃炎
剂量学
Esophageal neoplasms/postoperative radiotherapy
Radiation gastritis
Dosimetry
