| 张自成,徐瑾,李宝生,等.肺癌适形放疗后放射性肺损伤CT分级的危险因素研究[J].中华放射医学与防护杂志,2010,30(1):54-57.ZHANG Zi-cheng,XU Jin,LI Bao-sheng,et al.Risk factors for computed tomography grade of radiation-induced lung injury in lung cancer treated with three-dimensional conformal radiotherapy[J].Chin J Radiol Med Prot,2010,30(1):54-57 |
| 肺癌适形放疗后放射性肺损伤CT分级的危险因素研究 |
| Risk factors for computed tomography grade of radiation-induced lung injury in lung cancer treated with three-dimensional conformal radiotherapy |
| 投稿时间：2009-02-28 |
| DOI： |
| 中文关键词: 肺癌 三维适形放射治疗 放射性肺损伤 CT分级 |
| 英文关键词:Lung cancer Three-dimensional conformal radiotherapy Radiation-induced lung injury CT grade |
| 基金项目: |
| 作者 | 单位 | E-mail | | 张自成 | 250117 济南, 山东省肿瘤医院放疗科 | | | 徐瑾 | 250117 济南, 山东省肿瘤医院放疗科 | | | 李宝生 | 250117 济南, 山东省肿瘤医院放疗科 | baoshli@yahoo.com | | 尹勇 | 山东省肿瘤医院放疗科, 物理室 | | | 黄勇 | 山东省肿瘤医院放疗科, CT室 | | | 杨奉常 | 山东省肿瘤医院放疗科, CT室 | | | 李洪升 | 250117 济南, 山东省肿瘤医院放疗科 | | | 孙洪福 | 250117 济南, 山东省肿瘤医院放疗科 | | | 陈进琥 | 山东省肿瘤医院放疗科, 物理室 | | | 刘波 | 山东省肿瘤医院放疗科, 物理室 | |
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| 中文摘要: |
| 目的 探讨接受三维适形放疗(3DCRT)后影响严重放射性肺损伤CT分级的危险因素。方法 回顾性分析89例3DCRT的肺癌患者临床资料和随访CT影像资料,统计各临床因素及剂量体积参数。观察放疗结束6～12个月的CT影像资料并根据CT影像资料对放射性肺损伤进行评定分级。分析≥3级严重放射性肺损伤的危险因素。统计采用SPSS15.0软件。结果 89例患者放射性肺损伤CT分级情况:0级8例占9.0%,1级13例占14.6%,2级24例占27.0%,3级23例占25.8%,4级21例占23.6%。单因素分析显示同步化疗(CCT)、大体肿瘤体积(GTV)外放边界、患侧肺平均剂量、患侧肺的V15～V45差异有统计学意义。多因素Logistic回归分析显示:CCT、GTV外放边界和患侧肺V20是影响严重放射性肺损伤CT分级的独立危险因素。结论 对接受3DCRT的肺癌患者,CCT、GTV外放边界和患侧肺V20是影响严重放射性肺损伤CT分级的临床和剂量学危险因素。 |
| 英文摘要: |
| Objective To analyze the clinical and dosimetric risk factors for computed tomography(CT) grade of radiation-induced lung injury in lung cancer treated with three-dimensional conformal radiotherapy (3DCRT). Methods Eighty-nine lung cancer patients treated with 3DCRT were enrolled and CT scan images in more than 6 months were retrospectively analyzed. Clinical and dosimetric parameters were reviewed. Radiation-induced lung injuries were classified into 5 grades on CT images. Grade 3 or worse were considered clinically significant. Statistical software SPSS 15.0 was used to analyze the clinical and dosimetric risk factors that influenced the CT grade of radiation-induced lung injury. Results Eight of 89 patients (9.0%) developed grade 0 of radiation-induced lung injury, 13 developed grade 1(14.6%), 24 developed grade 2(27.0%), 23 developed grade 3(25.8%)and 21 developed grade 4(23.6%). Univariable analysis showed that concurrent chemotherapy(CCT), GTV margin, involved ipsilateral lung mean lung dose(IMLD), the percent of involved ipsilateral lung receiving over 15,20,25,30,35,40 and 45 Gy (V 15, V 20, V 25, V 30, V 35, V 40, V 45) were significantly associated with over grade 3 of radiation-induced lung injury . On multivariate logistic regression analysis, CCT, GTV margin and V 20 of ipsilateral lung emerged as statistically significant risk factors of over grade 3 radiation-induced lung injuries CT images. Conclusions CCT, GTV margin and V20 of ipsilateral lung might be clinical and dosimetric risk factors associated with the severe CT grade of radiation-induced lung injury for lung cancer treated with 3DCRT. |
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