Ⅲ期未手术非小细胞肺癌患者在调强放疗中发生放射性肺炎的影响因素分析  

Study on Influencing Factors of Radiation Pneumonia in Patients with StageⅢNon-small Cell Lung Cancer Undergoing Intensity Modulated Radiotherapy

作　　者：李花妮 姚培培 陈玉茹[1] 刘明国 和劲光[1] LI Huani;YAO Peipei;CHEN Yuru;LIU Mingguo;HE Jinguang(Heze Municipal Hospital,Shandong Province,Heze 274000,China;不详)

机构地区：[1]山东省菏泽市立医院,山东菏泽274000 [2]山东省郓城诚信医院

出　　处：《中国医学创新》2022年第2期69-72,共4页Medical Innovation of China

基　　金：2020年山东省医药卫生菏泽市立医院科技发展计划项目(2020YN11)。

摘　　要：目的:研究Ⅲ期未手术非小细胞肺癌患者在调强放疗中发生放射性肺炎的影响因素。方法:本研究采用前瞻性研究,选取2020年1月-2021年3月菏泽市立医院收治的90例Ⅲ期未手术非小细胞肺癌患者作为研究对象;所有患者均采取调强放射治疗,发生放射性肺炎患者28例,未发生放射性肺炎患者62例;对放射性肺炎进行单因素及多因素分析。结果:放射性肺炎组与非放射性肺炎组的性别、年龄比较,差异均无统计学意义(P>0.05);放射性肺炎组与非放射性肺炎组的肿瘤位置、基础肺疾病、吸烟情况、照射体积、临床靶体积、双肺接受5 Gy剂量照射的肺体积占全肺总体积的百分比(V5)、双肺接受20 Gy剂量照射的肺体积占全肺总体积的百分比(V20)、全肺平均剂量(MLD)比较,差异均有统计学意义(P<0.05)。多因素分析显示,肿瘤位置为周围型、存在基础肺疾病、吸烟、照射体积(>540 cm^(3))、临床靶体积(>186 cm^(3))、V5、V20、MLD较高均为患者发生放射性肺炎的危险因素(P<0.05)。结论:肿瘤位置为周围型、存在基础肺疾病、吸烟、较高的照射体积、临床靶体积、V5、V20、MLD均是Ⅲ期未手术非小细胞肺癌患者在调强放疗中发生放射性肺炎的危险因素,建议在患者的治疗中,及时对以上可控性因素进行调整,提升患者的生活质量。Objective:To study the influencing factors of radiation pneumonia in patients with stageⅢinoperative non-small cell lung cancer during intensity modulated radiotherapy.Method:A prospective study was used,90 patients with stageⅢnon-small cell lung cancer treated in Heze Municipal Hospital from January 2020 to March 2021 were selected as the research objects;all patients were treated with intensity modulated radiation therapy.There were 28 patients with radiation pneumonia and 62 patients without radiation pneumonia;Univariate and multivariate analysis were performed on radiation pneumonia.Result:There were no significant differences in gender and age between radiation pneumonia group and non radiation pneumonia group(P>0.05);the tumor location,basic lung disease,smoking status,irradiation volume,clinical target volume,lung volume irradiated with 5 Gy dose in both lungs as a percentage of total lung volume(V5),lung volume irradiated with 20 Gy dose in both lungs as a percentage of total lung volume(V20)and average lung dose(MLD)were compared between radiation pneumonia group and non radiation pneumonia group,the differences were statistically significant(P<0.05).Multivariate analysis showed that the tumor location of peripheral type,basic lung disease,smoking,irradiation volume(>540 cm^(3))and clinical target volume(>186 cm^(3)),high V5,V20 and MLD were the risk factors of radiation pneumonia(P<0.05).Conclusion:The tumor location of peripheral type,basic lung disease,smoking,high irradiation volume,clinical target volume,V5,V20 and MLD are the risk factors of radiation pneumonia in patients with stageⅢinoperative non-small cell lung cancer during intensity modulated radiotherapy.It is suggested that the above controllable factors should be adjusted in time in the treatment of patients to improve the quality of life of patients.

关 键 词：非小细胞肺癌 调强放疗 影响因素 放射性肺炎 

分 类 号：R734.2[医药卫生—肿瘤]