非小细胞性肺癌IMRT放疗后发生放射性肺损伤情况及影响因素  

Radiation lung injury and its influencing factors after IMRT radiotherapy for non-small cell lung cancer

作　　者：黄行志 刘高 曾建伦 鲁志兵[1] HUANG Xingzhi;LIU Gao;ZENG Jianlun;LU Zhibing(Department of Oncology,Pingxiang People's Hospital,Pingxiang,Jiangxi,337000,China)

机构地区：[1]萍乡市人民医院肿瘤科,江西萍乡337000

出　　处：《当代医学》2021年第26期10-12,共3页Contemporary Medicine

摘　　要：目的分析非小细胞性肺癌(NSCLC)调强适形放射治疗(IMRT)后发生放射性肺损伤(RILI)情况及影响因素,以指导未来临床干预措施的制定。方法选取2017年5月至2020年5月本院收治的NSCLC患者80例,所有患者均接受IMRT治疗,统计所有患者初次治疗后90 d内RILI发生情况,并收集患者临床资料,包括性别、年龄、糖尿病、慢性阻塞性肺疾病(COPD)、卡氏(KPS)评分、病理类型、肿瘤位置、化疗方式、化疗周期数、肿瘤分期、放疗剂量、大体肿瘤体积(GTV)、计划靶体积(PTV)与肺V20处剂量,分析非小细胞性肺癌IMRT放疗后发生RILI情况及影响因素。结果初次放疗后90 d内,80例患者中发生RILI 29例,发生率为36.25%;将全部可能的影响因素纳入,经单因素与多因素分析显示同期化疗、合并COPD、放疗剂量大、PTV、GTV大、V20处剂量高均为NSCLC患者IMRT放疗后发生RILI的影响因素(OR>1,P<0.05)。结论NSCLC患者IMRT放疗后有一定的RILI发生率,而同期化疗、合并COPD、总放疗剂量大、PTV、GTV大、V20处剂量高均为其发生的危险因素,临床可根据上述因素进行合理干预,以改善患者预后。Objective To analyze the occurrence and influencing factors of radiation lung injury(RILI)after intensity modulated radiotherapy(IMRT)for non-small cell lung cancer(NSCLC)and to guide the formulation of future clinical interventions.Methods 80 NSCLC patients admitted to our hospital from May 2017 to May 2020 were selected.All patients received IMRT treatment.The incidence of RILI within 90 days after the initial treatment of all patients was counted,and the clinical data of the patients were collected,including gender,age,Diabetes,chronic obstructive pulmonary disease(COPD),KPS score,pathological type,tumor location,chemotherapy method,number of chemotherapy cycles,tumor stage,radiotherapy dose,gross tumor volume(GTV),planned target volume(PTV)with the dose at the lung V20,the occurrence of RILI and its influencing factors after IMRT radiotherapy for non-small cell lung cancer were analyzed.Results Within 90 days after the initial radiotherapy,29 cases of the 80 patients had RILI,with an incidence rate of 36.25%;all possible influencing factors were included,and univariate and multivariate analysis showed that concurrent chemotherapy,combined COPD,high radiotherapy dose,PTV,GTV Large and high doses at V20 are the influencing factors for the occurrence of RILI in patients with NSCLC after IMRT radiotherapy(OR>1,P<0.05).Conclusion NSCLC patients have a certain incidence of RILI after IMRT radiotherapy,while concurrent chemotherapy,COPD,high total radiotherapy dose,PTV,GTV,and high dose at V20 are all risk factors for its occurrence.Therefore,clinical intervention can be carried out reasonably according to the above factors to improve the prognosis of patients.

关 键 词：非小细胞性肺癌 调强适形放射治疗 放射性肺损伤 放疗剂量 同期化疗 照射剂量 

分 类 号：R734.2[医药卫生—肿瘤]