V_(20)、MLD与放射性肺损伤的相关性研究  

Relation of V20 and MLD to radiation-induced lung injury

作　　者：蒋雪超[1] 崔洪霞[1] 宋红强[1] 

机构地区：[1]滨州市中心医院肿瘤科,山东滨州251700

出　　处：《中国癌症防治杂志》2011年第3期238-240,共3页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

摘　　要：目的研究V20、MLD与放射性肺损伤发生的相关性,指导临床放疗计划的制定,避免或减少放射性肺损伤,提高局部控制率,改善患者生存质量。方法自2008年8月至2010年6月,47例符合研究条件的肺癌患者入组。所有患者均接受三维适形放疗,应用6MVX-线照射,剂量50～70Gy/25～35f。制定放疗计划,生成剂量-体积直方图(DVH),得到物理参数V20及MLD,分析以上参数及其他临床因素对放射性肺损伤的影响,放疗计划要求V20≤30%,脊髓总量≤45Gy。放疗结束后定期行胸片及CT复查,根据辅助检查结果及临床表现诊断放射性肺损伤的发生,依据RTOG分级标准评价放射性肺损伤的程度。结果 47例中有15例发生放射性肺损伤,放射性肺损伤发生率为31.9%(15/47)。当V20≤25%和>25%时,放射性肺损伤发生率分别为14.3%和46.2%,差异有统计学意义﹙P<0.05﹚。当MLD≤15Gy和>15Gy时,放射性肺损伤发生率分别为14.3%和57.9%,差异有统计学意义﹙P<0.05﹚。结论 V20、MLD与放射性肺损伤有相关性,对预测放射性肺损伤有一定价值。Objective To investigate the relation of V20 and MLD to radiation-induced lung injury. Methods From Aug 2008 to Jun 2010,47 patients with lung cancer and met the study criteria were enrolled. All patients receive 3D conformal radiothera- py by 6MVX-ray, and the doses ranged between 50Gy to 70Gy. DVH was gained through 3-dimensional TPS. The radiation treat- ment planning was V20 ≤ 30% and the spinal cord volume was≤45Gy. Radiation-induced lung injury was diagnosed based on contrasted CT combined with clinical symptoms, and the extent of injury was evaluated according to RTOG grading crite- ria. Results The total incidence of radiation-induced lung injury was 31.9% （15/47）. While the incidence of lung injury was higher in the group of V20 〉 25% （46. 2% ） than that in the group of V20 ≤〈25% （ 14. 3%, P 〈 0. 05 ）. The incidence of lung injury was lower in the group of MLD≤ 15Gy （ 14. 3% ） than that in the group of MLD 〉 15Gy （57.9% ,P 〈0. 05）. Conclusion The radiation-induced lung injury related significantly to V20 and MLD that could help to predict the injury.

关 键 词：放射性肺损伤 肺癌 V20 MLD 

分 类 号：R734.2[医药卫生—肿瘤]