CT扫描估算剂量体积参数对老年Ⅲ期非小细胞肺癌患者放射性肺炎的预测效能  

Efficacy of CT Scan to Estimate Dose-volume Parameters in Predicting Radiation Pneumonia After Intensity Modulated Radiotherapy in Elderly Patients with Advanced Lung Cancer

作　　者：杨苗 YANG Miao(Department of Imaging,Zhengzhou Central Hospital,Zhengzhou 450007 China)

机构地区：[1]郑州市中心医院影像科,郑州450007

出　　处：《内蒙古医学杂志》2025年第3期282-286,共5页Inner Mongolia Medical Journal

摘　　要：目的探讨CT扫描估算剂量体积参数对老年Ⅲ期非小细胞肺癌患者胸部调强放疗后放射性肺炎(RP)的预测效能。方法选取2020年5月至2024年4月我院收治的286例老年Ⅲ期非小细胞肺癌患者作为本次研究对象,根据胸部调强放疗后是否发生RP分为RP组(n=69)和非RP组(n=217)。比较两组剂量体积参数;采用多因素Logistic逐步回归分析探讨老年Ⅲ期非小细胞肺癌患者调强放疗后RP的影响因素;采用受试者工作特征(ROC)曲线评估剂量体积参数对老年Ⅲ期非小细胞肺癌患者调强放疗后RP的预测价值。结果RP组V5、V10、V20、V30、MLD高于非RP组,差异有统计学意义(P<0.05)。RP组年龄≥70岁、有糖尿病史、肿瘤部位(中下肺)、治疗模式(同步化放疗)的比例均高于非RP组,差异有统计学意义(P<0.05)。多因素分析显示,有糖尿病史(OR=2.042,95%CI:1.429~2.917)、肿瘤部位(中下肺)(OR=2.237,95%CI:1.538~3.252)、V5(OR=2.784,95%CI:1.823~4.252)、V20(OR=2.380,95%CI:1.586~3.571)、MLD(OR=2.497,95%CI:1.661~3.753)是老年Ⅲ期非小细胞患者调强放疗后RP的独立危险因素(P<0.05)。ROC曲线分析显示,V5、V20、MLD预测老年Ⅲ期非小细胞肺癌患者胸部调强放疗后RP的曲线下面积(AUC)(95%CI)分别为0.901(0.848~0.954)、0.741(0.688~0.794)、0.836(0.687~0.889)。结论V5、V20、MLD对老年Ⅲ期非小细胞肺癌患者胸部调强放疗后RP具有一定的预测价值,且为患者调强放疗后RP的独立危险因素。Objective To investigate the predicting efficiency of CT scan to estimate dose volume parame-ters for radiation pneumonia(RP)after intensity modulated radiotherapy in elderly patients with advanced lung cancer.Methods 286 elderly patients with advanced lung cancer admitted to our hospital from May 2020 to April 2024 were selected as the subjects of this study.According to whether RP occurred after intensity modu-lated radiotherapy,they were divided into RP group(n=69)and non-RP group(n=217).The dose volume parameters of the two groups were compared.The influencing factors of RP after intensity modulated radiothera-py in elderly patients with advanced lung cancer were investigated by Multivariate Logistic stepwise regression analysis.The predictive value of dose volume parameters for RP after intensity modulated radiotherapy in elderly patients with advanced lung cancer were evaluated by ROC.Results V5,V10,V20,V30 and MLD in RP group were higher than those in non-RP group,and the difference was statistically significant(P<0.05).The pro-portions of age≥70 years old,history of diabetes,tumor site(middle and lower lung),clinical stage(stage II c),treatment mode(synchronous radiotherapy)in RP group were higher than those in non-RP group,and the dif-ferences were statistically significant(P<0.05).History of diabetes(OR=2.042,95%CI:1.429~2.917),tumor site(middle and lower lung)(OR=2.237,95%CI:1.538~3.252),V 5(OR=2.784,95%CI:1.823~4.252),V20(OR=2.380,95%CI:1.586~3.571),MLD(OR=2.497,95%CI:1.661-3.753)were independent risk factors for RP after intensity modulated radiotherapy in elderly patients with advanced lung cancer(P<0.05).ROC curve analysis showed that the area under the curve(AUC)(95%CI)of RP pre-dicted by V5,V20 and MLD after intensity modulated radiotherapy in elderly patients with advanced lung can-cer was 0.901(0.848~0.954),0.741(0.688~0.794)and 0.836(0.687~0.889),respectively.Conclusion RP in V5,V20,MLD patients with advanced lung cancer after intensity modulated radiotherapy has certain predictive value,and

关 键 词：剂量体积参数 Ⅲ期非小细胞肺癌 老年人 调强放疗 放射性肺炎 

分 类 号：R445[医药卫生—影像医学与核医学]