中下段食管癌调强放疗后放射性肺损伤临床分析  

Clinical Analysis of Radiation Induced Lung Injury after Intensity Modulated Radiation Therapy in the Middle and Lower Esophageal Cancer

作　　者：孟令新[1] 韩菁 周丹丹[1] 王传艳[1] 厉兵城 孟芹[1] 吴海英 

机构地区：[1]日照市人民医院肿瘤科,山东日照276826 [2]日照市人民医院放疗科,山东日照276826

出　　处：《肿瘤基础与临床》2018年第1期45-48,共4页journal of basic and clinical oncology

基　　金：山东省医药卫生科技发展计划项目(编号:2016WS0329);济宁医学院面上项目(编号:JY2016KY050Y)

摘　　要：目的探讨中下段食管癌调强放疗(IMRT)后放射性肺损伤的相关因素,为食管癌放疗的选择提供依据。方法入组72例食管癌患者均给予IMRT,并探讨IMRT后放射性肺损伤发生的相关因素。结果所有72例中下段食管癌患者1 a总生存率为94.44%。72例中下段食管癌患者中9例(12.50%)发生放射性肺损伤,均为1、2级。中下段食管癌患者的肿瘤病变长度、有无慢性阻塞性肺疾病及放疗总剂量与IMRT后放射性肺损伤发生有关。中下段食管癌IMRT中V10、V15、V20、V30、肺Dmean与放射性肺损伤有关(P均<0.05)。结论 V10、V15、V20、V30、肺Dmean是放射性肺损伤发生的关键影响因素,中下段食管癌IMRT中放射剂量学因素可较好预测放射性肺损伤发生。Objective To investigate the related factors of radiation induced lung injury after intensity modulated radiation therapy （IMRT） in the middle and lower esophageal cancer, and to provide the evidence for the selection of radiotherapy for esophageal carcinoma. Methods Seventy-two patients with middle and lower esophageal cancer received intensity modulated radiation therapy （IMRT）, and the related factors of radiation induced lung injury were analyzed too. Results The 1-year overall survival rate of all the 72 patients with middle and lower esophageal cancer was 94.44%. Nine patents （ 12.50% ） with grade 1 and 2 radiation-induced lung injury were observed of all the 72 patients with middle and lower esophageal cancer. Radiation-induced lung injury was related with length of tumor lesion, chronic obstructive pulmonary disease and total dose of radiation therapy （ P 〈 0.05 ）. Radiation-in- duced lung injury was related with V10, V15, V20, V30 and lung Dmean （P 〈 0.05）. Conclusion V10, V15, V20, V30 and lung Dmean are the key factors of radiation-induced lung injury. Radiation dosimetry in the IMRT for esophageal cancer can predict the incidence of radiation induced lung injury.

关 键 词：中下段食管癌 调强放疗 放射性肺损伤 放疗 

分 类 号：R735.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]