摘要
目的探讨食管癌调强放疗(IMRT)后剂量学参数差异对放射性肺炎(RP)发生及不同病情分级的影响。方法选取2019年6月至2023年11月界首市人民医院收治的80例食管癌患者,均实行IMRT计划,根据实施IMRT后患者是否发生RP分为发生RP组和未发生RP组,并将发生RP组根据其病情严重程度的不同进行分级。比较剂量学相关指标参数在发生RP组和未发生RP组以及不同分级RP中的差异,同时对剂量学参数数据进行Logistic多因素分析,总结剂量学相关指标的参数差异对RP发生及严重程度的影响。结果80例患者中有36例患者发生RP,44例患者未发生RP;发生RP患者中Ⅰ级20例,Ⅱ级13例,Ⅲ级3例。发生RP组的剂量学参数V10、V20、MLD均高于未发生RP组(P<0.05);3级RP患者的剂量学参数V10、V20、MLD均高于1级和2级RP患者,2级RP患者高于1级(P<0.05)。多因素分析显示:剂量学参数V10、V20以及MLD是食管癌患者应用IMRT计划后发生RP的独立危险因素。结论食管癌实行IMRT计划后发生RP及RP严重程度分级与剂量学参数差异有关;剂量学参数V10、V20、MLD是食管癌患者实行IMRT计划后发生RP的影响因素。
Objective To explore the effect of different dosimetric parameters after intensity modulated radiotherapy(IMRT)for esophageal cancer on the occurrence and grading of radiation pneumonia(RP).Methods Eighty esophageal cancer patients admitted to Jieshou People's Hospital from June 2019 to November 2023 were selected,all of whom implemented the IMRT plan.Patients were divided into RP group and non RP group based on whether they developed RP after the implementation of IMRT,and the RP group was graded according to the severity of their condition.The differences in dosimetry related indicator parameters between the RP group and the non RP group,as well as different grades of RP were compared.At the same time,logistic multiple factor analysis on dosimetry parameter data was performed to summarize the effect of different dosimetry related indicator parameters on the occurrence and severity of RP.Results Among the 80 patients,36 patients developed RP,while 44 patients did not.Among the RP patients,there were 20 gradeⅠpatients,13 gradeⅡpatients,and 3 gradeⅢpatients.The dosimetric parameters V10,V20,and MLD of the RP group were higher than those of the non RP group(P<0.05).The dosimetric parameters V10,V20,and MLD of gradeⅢRP patients were higher than those of gradeⅠand gradeⅡRP patients,while those of gradeⅡRP patients were higher than those of gradeⅠ(P<0.05).Multivariate analysis results showed that dosimetric parameters V10,V20,and MLD were independent risk factors for RP in esophageal cancer patients after using the IMRT plan.Conclusion The occurrence of RP and the severity grading of RP after implementing the IMRT plan for esophageal cancer are related to different dosimetric parameters.Dosimetric parameters V10,V20,and MLD are the influencing factors for RP in esophageal cancer patients after implementing the IMRT plan.
作者
段伟
刘飞
许光源
程宇豪
陈星
Duan Wei;Liu Fei;Xu Guangyuan;Cheng Yuhao;Chen Xing(Department of Tumor Radiotherapy,Jieshou City People's Hospital,Jieshou 236500,China;Department of Therapeutic Radiology,Jieshou City People's Hospital,Jieshou 236500,China)
出处
《中华消化病与影像杂志（电子版）》
2024年第4期320-324,共5页
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)
关键词
食管癌
放射性肺炎
调强放疗计划
剂量学参数
Esophageal cancer
Radiation pneumonia
Intensity modulated radiotherapy plan
Dosimetric parameters
