摘要
目的探讨非小细胞肺癌(NSCLC)患者行高剂量大分割放疗临床疗效与剂量学参数及放射性肺损伤的关系。方法选取Ⅲ~Ⅳ期NSCLC患者103例,采用高剂量大分割放疗对患者进行治疗,对NSCLC患者的放射性肺损伤情况进行评估,并对剂量学参数与NSCLC患者放射性肺损伤的相关性进行分析。结果103例Ⅲ~Ⅳ期NSCLC患者中,73例患者出现放射性肺炎,其中1级35例,2级28例,3级8例,4级2例;49例患者出现放射性肺纤维化,其中1级24例,2级18例,3级6例,4级1例。男性NSCLC患者放射性肺炎的发生率高于女性(P﹤0.05)。Logistic多元回归分析结果显示,V5与NSCLC患者发生≥3级放射性肺炎有关(P﹤0.05);V5、V20、V30和平均肺剂量与NSCLC患者发生≥2级放射性肺炎有关(P﹤0.05);V5、V10、V20、平均肺剂量、大体肿瘤体积和计划靶体积与NSCLC患者发生≥1级放射性肺炎有关(P﹤0.05);大体肿瘤体积和计划靶体积与NSCLC患者发生≥2级放射性肺纤维化有关(P﹤0.05)。结论放疗过程中剂量体积与NSCLC患者放射性肺损伤的发生密切相关,治疗过程中要综合考虑V5、V20、V30和平均肺剂量等指标参数。
Objective To investigate the relationship among clinical efficacy,dosimetric parameters and radiation-induced lung injury in patients with non-small cell lung cancer(NSCLC)treated with hypofractionated radiotherapy without surgical management.Method A total of 103 patients with stageⅢ-ⅣNSCLC were enrolled,who were treated with hypofractionated radiotherapy,among them,the occurrence of radiation-induced lung injury was observed,and the correlation between dosimetric parameters and radiation-induced lung injury in NSCLC patients was investigated.Result Amone the 103 NSCLC patients with stageⅢ-Ⅳ,73 patients developed radiation pneumonitis,including 35 cases with grade 1,28 cases with grade 2,8 cases with grade 3,and 2 cases with grade 4;49 patients developed radiation-induced pulmonary fibrosis,including 24 cases with grade 1,18 cases with grade 2,6 cases with grade 3,and 1 case with grade 4.The incidence of radiation pneumonitis in male NSCLC patients was higher than that in female patients(P<0.05).Logistic regression analysis showed that V5 was related to≥grade 3 radiation pneumonitis in NSCLC patients(P<0.05);V5,V20,V30 and average lung dose were related to≥grade 2 radiation pneumonitis in NSCLC patients(P<0.05);V5,V10,V20,average lung dose,and the gross tumor volume and planned target volume were related to≥grade 1 NSCLC patients of radiation pneumonitis(P<0.05);gross tumor volume and planned target volume was related to≥grade 2 radiation-induced pulmonary fibrosis in NSCLC patients(P<0.05).Conclusion The dose volume during radiation is closely related to the occurrence of radiation-induced lung injury.In the course of treatment,parameters such as V5,V20,V30 and average lung dose should be comprehensively considered.
作者
许群英
蒙以良
黄升武
XU Qunying;MENG Yiliang;HUANG Shengwu(Department of Radiation Oncology,Baise People’s Hospital,Baise 533000,Guangxi,China)
出处
《癌症进展》
2019年第21期2520-2523,共4页
Oncology Progress
关键词
非小细胞肺癌
放射性肺损伤
放疗
剂量学参数
non-small cell lung cancer
radiation-induced lung injury
radiotherapy
dosimetric parameters
