肺癌放疗患者放疗前肺功能与放射性肺炎发生的相关性  

Correlation Between Pulmonary Function Before Radiotherapy and Radiation Pneumonia in Patients with Lung Cancer

作　　者：党荣广 韩鲁军[1] 杨晔 张燕[1] 刘欣燕[2] 董英辉[3] DANG Rong-guang;HAN Lu-jun;YANG Ye;ZHANG Yan;LIU Xin-yan;DONG Ying-hui(Shijiazhuang N0.1 Hospital.Shijiazhuang 050011,China;Hebei Provincial Thoracic Hospital,Shijiazhuang 050000,China)

机构地区：[1]河北省石家庄市第一医院,河北石家庄050011 [2]河北省胸科医院,河北石家庄050000 [3]石家庄市第一医院肿瘤科一病区,河北石家庄050011

出　　处：《肿瘤学杂志》2021年第3期191-195,共5页Journal of Chinese Oncology

基　　金：河北省医学科学研究计划项目(20191462)。

摘　　要：[目的]探究放疗前肺功能与肺癌放疗患者放射性肺炎(radiation pneumonia,RP)发生的关系。[方法]选择2015年3月至2018年9月行放射治疗的167例肺癌患者,随访6个月,失访11例。根据RP分级标准,将患者分成正常组(0~Ⅰ级,n=124)和放射性肺炎组(Ⅱ~Ⅴ级,n=32)。单因素分析两组患者一般资料,对差异有统计学意义的指标行Logistic多因素回归分析评价肺功能与RP发生的关系。[结果]两组患者在第1秒用力呼气容积(forced expiratory volume in one second,FEV1.0)、FEV1.0/用力肺活量(forced vital capacity,FVC)、一氧化碳弥散量(diffusing capacity of the lung for carbon monoxide,DLCO)、双肺全肺平均照射剂量、肺接受5、20和30Gy剂量与全肺体积的占比(V5、V20及V30)及计划靶区体积(planning target volume,PTV)等指标差异有统计学意义(P<0.05)。Logistic回归分析表明FEV1.0(OR=0.751,95%CI:0.615~0.917)、FEV1.0/FVC(OR=0.711,95%CI:0.549~0.921)、DLCO(OR=0.465,95%CI:0.293~0.739)、血清涎液化糖链抗原-6(OR=2.998,95%CI:2.058~4.368)、血清IL-17A(OR=2.683,95%CI:1.683~4.278)及MLD(OR=2.401,95%CI:1.228~4.694)等6项指标具有显著统计学意义(P<0.05)。[结论]FEV1.0、FEV1.0/FVC和DLCO等放疗前肺功能参数是RP发生的独立危险因素,可作为RP疾病诊断、治疗和预后评估的重要指标。[Objective]To explore the correlation between pulmonary function before radiotherapy and radiation pneumonia(RP)in patients with lung cancer.[Methods]A total of 156 patients with lung cancer undergoing radiotherapy during March 2015 to September 2018 were enrolled in this study.According to classification of radiation pneumonia,the patients were divided into normal group(grade 0~Ⅰ,n=124)and RP group(gradeⅡ~Ⅴ,n=32).The lung function was examined before radiotherapy and the relationship between lung function and the occurrence of radiation pneumonia was analyzed.[Results]There were significant differences in forced expiratory volume in one second(FEV1.0),FEV1.0/forced vital capacity(FVC),diffusing capacity of the lung for carbon monoxide(DLCO),MLD,V5,V20,V30,planning target volume,serum Krebs von den lungen-6(KL-6)and serum interleukin-17 A(IL-17A)between RP group and normal group.Logistic regression analysis showed that FEV1.0(OR=0.751,95%CI:0.615~0.917),FEV1.0/FVC(OR=0.711,95%CI:0.549~0.921),DLCO(OR=0.465,95%CI:0.293),serum KL-6(OR=2.998,95%CI:2.058~4.368),serum IL-17A(OR=2.683,95%CI:1.683~4.278)and MLD(OR=2.401,95%CI:1.228~4.694)were associated with the occurrence of radiation pneumonia(P<0.05).[Conclusion]Pulmonary function parameters such as FEV1.0,FEV1.0/FVC and DLCO before radiotherapy are independent risk factors for RP and can be used as predictors for RP.

关 键 词：肺功能 肺癌 放射性治疗 放射性肺炎 相关性 

分 类 号：R734.2[医药卫生—肿瘤]