| 封巍,祝淑钗,李任,邱嵘,李娟,王玉祥.三维适形放射治疗Ⅲ期中央型非小细胞肺癌所致食管损伤相关因素分析[J].中华放射医学与防护杂志,2005,25(2):147-150 |
| 三维适形放射治疗Ⅲ期中央型非小细胞肺癌所致食管损伤相关因素分析 |
| Analyzing predictors of radiation-induced esophageal toxicity in patients with stage Ⅲ unresectable non-small cell lung cancer treated with three-dimensionalconformal radiotherapy. |
| 投稿时间：2004-03-18 |
| DOI： |
| 中文关键词: 非小细胞肺癌 三维适形放射治疗 放射性食管损伤 |
| 英文关键词:Non-small cell lung cancer Conformal radiotherapy Radiation esophagitis |
| 基金项目:河北省自然科学基金资助项目(301393) |
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| 摘要点击次数: 2585 |
| 全文下载次数: 2020 |
| 中文摘要: |
| 目的 分析三维适形放射治疗局部晚期中央型非小细胞肺癌(NSCLC)患者导致放射性食管损伤的临床物理因素。方法 2000年8月至2002年12月,56例NSCLC患者接受三维适形放射治疗,对三维适形计划及患者临床资料进行单因素、多因素分析,评价食管损伤。结果 56例NSCLC中,共发生急性食管炎24例,Ⅰ级14例、Ⅱ级5例、Ⅲ级5例。后期食管反应7例,Ⅰ级2例、Ⅱ级1例、Ⅲ级4例。相关分析显示与急性食管炎相关的因素有食管V50、食管所受平均剂量、同期化疗;与后期食管损伤相关的因素有肿瘤GTV,大分割照射,急性食管炎。Logistic多元回归结果显示急性放射性食管炎发生的影响因素为化疗、食管V50(OR值分别为2990,1041)。后期食管反应影响因素为肿瘤GTV,食管NTCP(OR值分别为3839,2465)。采用KaplanMeier计算生存率,Logrank法进行统计学检验,急性放射性食管炎、后期食管反应与生存率均无关(P=0621;P=0545)。结论 NSCLC放射治疗过程中是否接受化学治疗以及食管V50是引起急性放射性食管损伤的主要原因;肿瘤GTV和食管NTCP是引起后期放射性食管反应的主要因素。 |
| 英文摘要: |
| Objective To evaluate clinical and dosimetric predictors of acute and late esophageal toxicity in patients with stage Ⅲ non-small-cell lung cancer (NSCLC) treated with three-dimensional conformal radiotherapy(3D-CRT).Methods We retrospectively reviewed 56 patients with NSCLC who were treated with 3D-CRT between August 2000 and December 2002. The clinic factors and treatment parameters were collected and coded.Acute and late esophageal toxicities were graded. All factors correlating with acute and late esophageal toxicity were analyzed. Results 24 patients (42.8%) developed acute esophageal toxicity, 7 patients(12.5%) developed late esophageal toxicity,according to RTOG scores, the acute esophageal toxicities were graded: Ⅰ-14、Ⅱ-5、Ⅲ-5; late esophageal toxicity were graded :Ⅰ-2、Ⅱ-1、Ⅲ-4. Spearman rank correlation coefficients showed that chemotherapy, percentages of esophagus volume receiving >50Gy(V50 ), the average dose to the esophagus, correlated with acute esophageal toxicity, and the gross tumor volume (GTV),the fraction of radiotherapy were significantly correlated with late esophageal toxicity. Binary Logistic regression analysis showed chemotherapy, esophageal V50,were the independent risk factors of acute esophageal toxicity. Esophageal NTCP and GTV were the independent risk factors of late esophageal toxicity. There were not relation between the survival ratio and acute,late esophageal toxicity. Conclusions In stage III NSCLC patients treated with 3D-CRT, chemotherapy and esophageal V50 were significantly associated with a risk of acute esophageal toxicity; esophageal NTCP and GTV were the independent risk factors of late esophageal toxicity. |
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