| 张自成,和劲光,李宝生,等.非小细胞肺癌适形放射治疗中急性放射性食管炎影响因素的研究[J].中华放射医学与防护杂志,2011,31(5):559-563.ZHANG Zi-cheng,HE Jin-guang,LI Bao-sheng,et al.Clinical and dosimetric risk factors of acute radiation esophagitis in non-small cell lung cancer patients treated with three-dimensional conformal radiotherapy[J].Chin J Radiol Med Prot,2011,31(5):559-563 |
| 非小细胞肺癌适形放射治疗中急性放射性食管炎影响因素的研究 |
| Clinical and dosimetric risk factors of acute radiation esophagitis in non-small cell lung cancer patients treated with three-dimensional conformal radiotherapy |
| 投稿时间：2010-08-14 |
| DOI：10.3760/cma.j.issn.0254-5098.2011.05.014 |
| 中文关键词: 非小细胞肺癌 三维适形放射治疗 急性放射性食管炎 |
| 英文关键词:Non-small cell lung cancer Three-dimensional conformal radiotherapy Acute radiation esophagitis |
| 基金项目:国家自然科学基金(30670617) |
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| 中文摘要: |
| 目的 探讨接受三维适形放疗(3D-CRT)的非小细胞肺癌(NSCLC)患者发生≥2级急性放射性食管炎(ARE)的影响因素。方法 回顾102例接受3D-CRT的NSCLC患者的临床资料及三维计划资料,采用RTOG分级标准,评价患者自放疗开始3个月内≥2级的ARE。分析临床因素和三维计划的剂量体积参数。结果 发生2级ARE19例,3级15例,未出现更严重的ARE。非同步化疗组多因素回归分析显示,食管V55(OR=1.170,P<0.05)为≥2级ARE发生的惟一影响因素,食管V55的ROC曲线下面积为0.870(95%CI: 0.782~0.957,P＜0.05),界值为16.0。同步化疗组多因素回归分析显示,食管V35(OR=1.125,P<0.05)和同步化疗方案(OR=39.740,P<0.05)是≥2级ARE发生的影响因素,食管V35的ROC曲线下面积为0.782(95%CI: 0.636~0.927,P<0.05),界值为23.75。长春瑞滨+顺铂(NP)同步化疗方案的≥2级ARE发生率明显低于其他方案(33.3% ∶66.7%)。结论 非同步化疗患者,食管V55是≥2级ARE的影响因素。同步化疗患者,食管V35和同步化疗方案是≥2级ARE的影响因素。同步NP方案≥2级ARE发生率较低。 |
| 英文摘要: |
| Objective To analyze the clinical and dosimetric risk factors for acute radiation esophagitis (ARE) in non-small cell lung cancer (NSCLC) patients treated with three-dimensional conformal radiotherapy (3D-CRT), and to find significant risk factors for clinical therapy. Methods A total of 102 NSCLC patients treated with 3D-CRT were retrospectively analyzed. ARE was scored according to the Radiation Therapy Oncology Group (RTOG) criteria with grade 2 or worse. Patients were divided into non-concurrent chemoradiotherapy group and concurrent chemoradiotherapy group. The clinical and dosimetric factors associated with grade 2 or worse ARE were analyzed using univariate logistic regression, multivariate logistic analysis and receiver operating characteristic (ROC) curve. Results There were no grade 4 or 5 ARE observed in the 102 patients. Nineteen developed grade 2, 15 developed grade 3.In non-concurrent chemoradiotherapy group, multivariate analysis showed that V55 was the only risk factor of grade 2/3 ARE. For ROC curve analysis, the cut-off point of V55 was 16.0 while the area under ROC curve was 0.870 (95%CI: 0.782-0.957,P<0.05). In concurrent chemoradiotherapy group, multivariate analysis showed that V35 and chemotherapy regimens during radiotherapy were risk factors of grade 2/3 ARE. The cut-off point of V35 was 23.75 while the area under ROC curve was 0.782 (95%CI: 0.636-0.927,P＜0.05). Vinorelbine and cisplatin regimen showed low incidence of ARE contrast with gemcitabine/docetaxel and cisplatin regimens (33.3% and 66.7%). Conclusions V55 is the only statistically significant risk factor associated with grade 2 or worse ARE for patients who don't accepted concurrent chemotherapy. V35 and chemotherapy regimens during radiotherapy are statistically significant risk factors associated with grade 2 or worse ARE for patients who accept concurrent chemotherapy. Vinorelbine and cisplatin regimen during radiotherapy shows low incidence of ARE. |
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