剂量体积参数及CRP与食管癌放疗后放射性肺炎的相关性  

Correlation Between Dose Volume Parameters and CRP and Radiation Pneumonitis After Radiotherapy for Esophageal Carcinoma

作　　者：庞然然[1] PANG Ranran(The First Affiliated Hospital of Henan University of Science and Technology,Zhengzhou,450000)

机构地区：[1]河南科技大学第一附属医院,471000

出　　处：《实用癌症杂志》2023年第9期1540-1543,共4页The Practical Journal of Cancer

摘　　要：目的探讨剂量体积参数及C反应蛋白(CRP)与食管癌放疗后放射性肺炎的相关性。方法回顾性选取食管癌患者76例,经放射治疗后观察食管癌患者放射性肺炎发生情况,分为放射性肺炎组和无放射性肺炎组。收集患者一般资料、临床资料和总剂量、90%计划靶区接受剂量(PTVD_(90)),50 Gy照射计划靶区相应占比(PTVV_(50))、双肺体积、肺剂量体积参数V5~V40、肺平均剂量(MLD)等,检测患者放疗前、放疗一周、放疗后CRP。结果76例食管癌患者放射性肺炎发生率40.79%。临床分期、放疗模式、放疗剂量影响食管癌患者放射治疗后放射性肺炎发生(P<0.05)。食管癌患者放疗一周、放疗后CRP水平高于放疗前,放疗后CRP水平高于放疗一周(P<0.05);放射性肺炎患者放疗一周和放疗后CRP水平均高于无放射性肺炎患者(P<0.05);通过Pearson相关性评估CRP与放射性肺炎之间存在相关性(γ=0.359,P<0.001)。食管PTVD_(90)、食管PTVV_(50)、总剂量、MLD、V5、V10、V15、V20与放射性肺炎发生相关,且为放射性肺炎发生的独立危险因素(P<0.05)。结论放射性肺炎发生与食管癌患者病情严重程度、放射剂量体积参数及CRP水平相关,总剂量、低剂量体积参数是食管癌患者放射性肺炎的危险因素。临床放射治疗计划制定中应注意低剂量体积参数及患者治疗总剂量限制。Objective To investigate the correlation between dose-volume parameters and C-reactive protein(CRP)and radiation pneumonitis after radiotherapy for esophageal carcinoma.Methods Retrospective selection of 76 patients with esophageal cancer,after radiotherapy,the incidence of radiation pneumonitis in patients with esophageal cancer was observed,and they were divided into radiation pneumonitis group and non radiation pneumonitis group.Collect general patient information,clinical data,total dose,90%planned target area acceptance dose(PTVD_(90)),corresponding proportion of 50 Gy irradiation plan target area(PTVV_(50)),bilateral lung volume,lung dose volume parameters V5~V40,lung mean dose(MLD),etc.,and detect the CRP of patients before,one week after,and after radiotherapy.Results The incidence of radiation pneumonia in 76 patients with esophageal cancer was 40.79%.Clinical stage,radiation mode,and radiation dose affected the occurrence of radiation pneumonitis in patients with esophageal cancer after radiotherapy(P<0.05).The CRP level of esophageal cancer patients after one week of radiotherapy was higher than that before radiotherapy,and the CRP level after radiotherapy was higher than that after one week of radiotherapy(P<0.05).The level of CRP in patients with radiation pneumonitis was higher than that in patients without radiation pneumonitis one week after radiotherapy and after radiotherapy(P<0.05);Pearson correlation was used to assess the correlation between CRP and radiation pneumonitis(γ=0.359,P<0.001).Esophageal PTVD_(90),esophageal PTVV_(50),total dose,MLD,V5,V10,V15,V20 are associated with the occurrence of radiation pneumonia and are independent risk factors for the occurrence of radiation pneumonia(P<0.05).Conclusion The occurrence of radiation pneumonitis is related to the severity of esophageal cancer patients,radiation dose volume parameters,and CRP levels.Total dose and low dose volume parameters are risk factors for radiation pneumonitis in esophageal cancer patients.Attention should be paid to t

关 键 词：食管癌 C反应蛋白 放射性肺炎 放射治疗 

分 类 号：R735.1[医药卫生—肿瘤]