肺气肿与非小细胞肺癌患者放疗后放射性肺炎的相关影响因素  

Influencing Factors of Emphysema and Radiation Pneumonia After Radiotherapy in Non-Small Cell Lung Cancer Patients

作　　者：马宋坤 张伟林[1] 马志平 赵淑灿[1] MA SongKun;ZHANG Weilin;MA Zhiping(Shantou Central Hospital, Guangdong Shantou 515000,China)

机构地区：[1]广东省汕头市中心医院,广东汕头515000

出　　处：《河北医学》2021年第8期1353-1358,共6页Hebei Medicine

基　　金：广东省汕头市科技计划医疗卫生类别项目,(编号:201111166491113)。

摘　　要：目的:探究肺气肿与非小细胞肺癌患者放疗后放射性肺炎的相关影响因素。方法:回顾性选取2012年1月至2018年12月经我院初治的经病理确诊为局部晚期非小细胞肺癌(NSCLC)患者166例为研究对象。根据患者放疗后3个月≥2级放射性肺炎(RP)发生状况将患者分为RP组40例、无RP组126例。本研究旨在探索局部晚期非小细胞肺癌患者放疗后放射性肺炎的相关影响因素,并分析肺气肿与RP分级相关性。结果:多因素Logistic回归分析显示,肺气肿、同期放化疗、肺平均剂量、CTV体积、V5、V20、V30、V40是NSCLC患者放疗后发生RP的相关影响因素(P<0.05)。Spearman相关性显示,肺气肿分级情况与NSCLC患者RP分级情况呈显著正相关(P<0.05)。结论:肺气肿、同期放化疗、肺平均剂量、CTV体积、V5、V20、V30、V40是局部晚期NSCLC患者放疗后发生≥2级RP的相关影响因素,局部晚期NSCLC患者临床治疗应充分考虑各方面因素,制定合理放疗方案,降低RP发生情况。Objective:To explore the related factors of emphysema and radiation pneumonia after radiotherapy in patients with non-small cell lung cancer.Methods:From January 2012 to December 2018,166 patients with locally advanced non-small cell lung cancer(NSCLC)were diagnosed by pathology.Patients were divided into RP group(N=40)and NON-RP group(N=126)according to the occurrence of grade 2 radiation pneumonia(RP)3 months after radiotherapy.The purpose of this study was to explore the related factors of radiation pneumonia after radiotherapy in patients with locally advanced non-small cell lung cancer,and analyze the correlation between emphysema and RP grades.Results:Multivariate Logistic regression analysis showed that emphysema,concurrent radiotherapy and chemotherapy,mean lung dose,CTV volume,and V5、V20、V30、V40 were related factors for RP after radiotherapy(P<0.05).Spearman correlation showed that emphysema grade was significantly positively correlated with RP grade of NSCLC patients(P<0.05).Conclusion:Emphysema,simultaneous radiotherapy and chemotherapy,mean lung dose,CTV volume,V5、V20、V30、V40 are related factors for≥grade 2 RP after radiotherapy in patients with local advanced stage.Clinical treatment of patients with local advanced stage should fully consider all factors and formulate reasonable radiotherapy plan to reduce the occurrence of RP.

关 键 词：非小细胞肺癌 放射性肺炎 肺气肿 影响因素 相关性 

分 类 号：R73[医药卫生—肿瘤]