| Du Feng,Wang Qiang,Wang Wei,et al.Analysis of related factors of radiation pneumonitis after radiotherapy for thoracic segment esophageal cancer[J].Chinese Journal of Radiological Medicine and Protection,2020,40(11):832-839 |
| Analysis of related factors of radiation pneumonitis after radiotherapy for thoracic segment esophageal cancer |
| Received:July 04, 2020 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.11.004 |
| KeyWords:Esophageal cancer Radiotherapy technology Radiation pneumonia Risk factor |
| FundProject:国家重点研发计划项目（2016YFC0904700）；国家自然基金面上项目（81773287）；山东省重点研发计划项目（2016GSF201093） |
| Author Name | Affiliation | E-mail | | Du Feng | Department of Radiation Oncology, Zibo Municipal Hospital, Zibo 255400, China | | | Wang Qiang | Department of Radiation Oncology, Zibo Municipal Hospital, Zibo 255400, China | | | Wang Wei | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Zhang Yingjie | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Li Zhenxiang | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | | | Li Jianbin | Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117, China | lijianbin@msn.com |
|
| Hits: 3526 |
| Download times: 1521 |
| Abstract:: |
| Objective To investigate the effects of clinical characteristics, irradiation techniques and dose-volume parameters on radiation pneumonitis(RP) in thoracic segment esophageal cancer patients, so as to provide reference for the formulation of radiotherapy protocol for thoracic esophageal cancer. Methods The incidence of RP in 247 patients with thoracic segment esophageal cancer from June 2014 to June 2019 was analyzed retrospectively, then univariate and multivariate analyses were performed on the clinical characteristics, radiation techniques and lung dosimetry parameters of these patients. The area under receiver operating characteristic (ROC) curve was used to verify the diagnostic efficacy of RP≥grade 1, ≥grade 2 and ≥grade 3. Results There were 118 cases (47.8%)with RP≥grade 1, 54 cases (21.9%)with RP≥grade 2,17 cases (6.9%)with RP≥grade 3. The result of univariate analysis showed that lung V5-V40 and MLD were both related to the occurrence of RP≥grade 1(Z=-5.802 to -4.306,P<0.05). ≥grade 2,and≥grade 3, respectively(F=0.057 to 11.616、0.087 to 3.392,P<0.05). GTV volume, PTV volume, GTV/lung volume(%) and PTV/lung volume(%) were related to RP≥grade 1(Z=-3.377 to -2.041,P<0.05)and RP≥grade 2(F=3.600 to 9.801,P<0.05). Smoking index >400 was significantly correlated with RP≥grade 3(χ2=13.295, P<0.05), and chronic obstructive pulmonary disease (COPD) was significantly correlated with RP≥grade 1(χ2=9.146, P<0.05). However, there was no significant correlation between RP and different irradiation techniques, chemotherapy factors, radiotherapy dose, esophageal cancer stage and cancer location.The result of multivariate analysis showed that V5 and V40 were independent risk factors of RP≥grade 1(AUC 55.74%、4.13%)、MLD was independent risk factors of RP≥grade 2 (AUC 11.91 Gy), and V5 was independent risk factors of RP≥grade 3(AUC 57.60%). The smoking index>400 was the independent risk factor of RP≥grade 3 (Wald＝5.964,P<0.05), and COPD was the independent risk factor of RP≥1 grade (Wald＝6.110, P<0.05). Conclusions The incidence of RP is low after radiotherapy for thoracic segment esophageal cancer. The dosimetric parameters such as lung V5, V40, MLD, smoking degree, COPD and other clinical characteristics are closely related to the occurrence of RP of corresponding grades. |
| HTML View Full Text View/Add Comment Download reader |
| Close |
|
|
|
