乳腺癌改良根治术后常规分割放疗患者并发放射性肺炎的危险因素分析  

Analysis of Risk Factors for Radiation Pneumonitis in Patients with Conventional Fractionated Radiotherapy after Modified Radical Mastectomy for Breast Cancer

作　　者：莫月媚[1] 蔡悦成[1] 黄明英[1] MO Yuemei;CAI Yuecheng;HUANG Mingying(The First People’s Hospital of Zhaoqing,Guangdong Province,Zhaoqing 526000,China;不详)

机构地区：[1]广东省肇庆市第一人民医院,广东肇庆526000

出　　处：《中国医学创新》2022年第28期10-14,共5页Medical Innovation of China

基　　金：肇庆市科技计划项目(2021040307012)。

摘　　要：目的:分析影响乳腺癌改良根治术后常规分割放疗患者并发放射性肺炎的危险因素。方法:回顾性分析肇庆市第一人民医院2019年6月-2021年6月收治的80例乳腺癌患者,均实施乳腺癌改良根治术后辅助放疗,根据患者是否并发放射性肺炎分为肺炎组(n=16)和无肺炎组(n=64),对两组临床资料进行单因素对比,选择比较存在明显差异的指标进行非条件logistic多元逐步回归分析。结果:两组体重指数(BMI)、靶向治疗、内分泌治疗情况、放疗模式、放疗技术、乳腺癌病理、乳腺癌分期因素比较,差异均无统计学意义(P>0.05);肺炎组患者中高龄、化疗、放疗天数(长周期)、放疗剂量(>50 Gy)、放疗照射视野面积(≥120 cm^(2))比例均高于无肺炎组,差异均有统计学意义(P<0.05)。经非条件logistic多元逐步回归分析可知,化疗、放疗天数、放疗剂量>50 Gy、放疗照射视野面积≥120 cm^(2)均为影响乳腺癌改良根治术后辅助放疗患者并发放射性肺炎的独立危险因素(P<0.05)。结论:乳腺癌改良根治术后辅助放疗患者并发放射性肺炎受到化疗情况、放疗天数、放疗剂量>50 Gy、放疗照射视野面积≥120 cm^(2)等独立因素影响,临床可根据以上独立因素制订防治对策,降低乳腺癌改良根治术后辅助放疗患者并发放射性肺炎风险。Objective:To analyze the risk factors of radiation pneumonitis in patients with conventional fractionated radiotherapy after modified radical mastectomy for breast cancer.Method:A total of 80 patients with breast cancer treated in the First People’s Hospital of Zhaoqing were retrospectively analyzed from June 2019 to June 2021.All patients were treated with adjuvant radiotherapy after modified radical mastectomy for breast cancer,and they were divided into pneumonia group(n=16)and non-pneumonia group(n=64)according to whether the patients with radiation pneumonia.Univariate comparison analysis were performed on the clinical data of the two groups,and the indicators with significant differences were selected for unconditional logistic multivariate stepwise regression analysis.Result:There were no statistical differences in body mass index(BMI),targeted therapy,endocrinotherapy,radiotherapy mode,radiotherapy technology,breast cancer pathology and breast cancer staging between the two groups(P>0.05).The rate of elderly patients,patients with chemotherapy,the number of radiotherapy days(long period),radiotherapy dose(>50 Gy)and irradiation field area(≥120 cm^(2))in pneumonia group were higher than those in non-pneumonia group(P<0.05).Unconditional logistic multivariate stepwise regression analysis showed that chemotherapy,the number of radiotherapy days,radiotherapy dose>50 Gy and irradiation field area≥120 cm^(2) were independent risk factors affecting the occurrence of radiation pneumonitis in patients with adjuvant radiotherapy after modified radical mastectomy for breast cancer(P<0.05).Conclusion:Radiation pneumonitis in patients with adjuvant radiotherapy after modified radical mastectomy for breast cancer is influenced by independent factors such as chemotherapy,the number of radiation days,radiotherapy dose>50 Gy and irradiation field area≥120 cm^(2).It is feasible to formulate clinical prevention and treatment countermeasures according to the above independent factors so as to reduce the risk of radia

关 键 词：乳腺癌改良根治术 辅助放疗 放射性肺炎 危险因素 防治对策 

分 类 号：R737.9[医药卫生—肿瘤]