肿瘤防治研究2014，Vol.41Issue(12)：1307-1312,6.DOI:10.3971/j.issn.1000-8578.2014.12.012
Ⅲ期非小细胞肺癌三维适形放疗所致放射性肺炎的影响因素
Influence Factors for Radiation Pneumonitis in Stage Ⅲ Non-small Cell Lung Cancer Patients Treated with Three-dimensional Conformal Radiotherapy
王玉祥 1田丹丹 2邱嵘 1田秀明 1王丽丽1
作者信息
- 1. 050011石家庄,河北医科大学第四医院放疗科
- 2. 061001沧州,河北省沧州市中西医结合医院放疗科
- 折叠
摘要
Abstract
Objective To retrospectively analyze physical parameters and clinical factors for radiation pneumonitis(RP) in stage Ⅲ non-small cell lung cancer(NSCLC) patients treated with three-dimensional conformal radiotherapy(3D-CRT).Methods From January 2001 to December 2008,203 NSCLC patients were treated with radical 3D-CRT,163 males and 40 females; Median ages was 63-year-old(30～83); 21 patients were suffered from chronic obstructive pulmonary disease(COPD) medical history; 79 cases were in ⅢA stage and 124 cases were in ⅢB stage; 70 cases were treated with single radiotherapy and 133 cases with chemoradiotherapy,and median equivalent dose was 6 200 cGy (5 000-7 800 cGy).RP was evaluated with RTOG standard,and physical parameters of DVH was used to estimated RP grade≥2 and RP grade≥ 3.SPSS 13.0 software was used for statistic analysis.Results After 3DCRT,the rates of RP grade≥2 and grade ≥ 3 were 32％(65/203) and 20.7％(42/203).Spearman correlation and single factor Logistic analysis showed that the mean lung dose,V5-V40 of total lung,COPD history,fractional radiation style,radiotherapy dose,GTV and GTV/volume of total lung were correlated with RP grade≥2 and grade≥≥3 (P＜0.05); Logistic multivariate analysis revealed that V25 was the independent risk factor for RP grade ≥ 2 and grade ≥ 3.The optimal cutoff value for lung V25 was 29％ in the receiver-operating characteristic (ROC) curve.COPD was the independent risk factor for RP grade ≥2.Conclusion DVH parameters were associated with the occurrence of RP.V25 might be the most effectively independent risk factor for RP grade≥2 and grade ≥3.COPD was the independent risk factor for RP grade ≥ 2 in patients with non-small cell lung cancer.关键词
Ⅲ期非小细胞肺癌/三维适形放疗/放射性肺炎Key words
Stage Ⅲ non-small cell lung cancer/ Three-dimensional conformal radiotherapy(3D-CRT)/Radiation pneumonitis(RP)分类
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王玉祥,田丹丹,邱嵘,田秀明,王丽丽..Ⅲ期非小细胞肺癌三维适形放疗所致放射性肺炎的影响因素[J].肿瘤防治研究,2014,41(12):1307-1312,6.
