摘要
目的 探讨非小细胞肺癌化疗同期三维适形或调强放疗中位剂量70 Gy时临床因素与放射性肺炎（RP）的相关性.方法 采用三维适形或调强后程加速超分割放疗经病理或细胞学证实初治的非小细胞肺癌患者84例,同期化疗78例,化疗采用紫杉醇或多西紫杉醇或长春瑞滨＋顺铂或卡铂一线方案.单因素分析病理类型、治疗方式、年龄、性别、临床分期、卡氏评分、吸烟、糖尿病、慢性阻塞性肺病（COPD）与RP相关性,对其中P＜0.10因素代入Logistic回归模型进行多因素分析.结果 84例患者中≥1级RP发生率为63%,≥2级为33%.单因素分析显示糖尿病与≥1级RP（x2=4.03,P=0.045）及≥2级RP相关（x2=15.59,P=0.000）,卡氏评分与≥1级RP（x2=3.98,P=0.046）及≥2级RP相关（x2=5.21,P=0.023）.多因素分析显示糖尿病与≥1级RP（x2=5.50,P=0.019）及≥2级（x2=12.92,P=0.000）RP发生相关,卡氏评分与≥1级RP（x2=6.29,P=0.012）及≥2级RP（x2=6.61,P=0.010）发生相关.结论 糖尿病、卡氏评分是非小细胞肺癌患者发生RP的危险因素,制定放疗计划时充分考虑可减少RP发生机会.
Objective To evaluate clinical factors as predictors of radiation pneumonitis（RP）in advanced stage non-small cell lung cancer（NSCLC）patients treated with concurrent radiochemotherapy when gross tumor volume is 70 Gy. Methods Data of 84 patients with histologically proved NSCLC treated with 3DCRT or IMRT were collected. To evaluate the correlation between clinical parameters and radiation pneumonitis（RP）. The clinical parameters were considered： pathological type, therapy agents, age,gender, stage, karnofsky performance status（KPS）, smoking status, diabetes, chronic obstructive pulmonary disease（COPD）. Results The occurrence of grade 1,2 RP was 63%, 33%, respectively. In univariate analysis, diabetes was significantly associated with RP of ≥ grade 1（x2 =4.03, P = 0.045）and ≥grade 2（x2 = 15.59 ,P =0.000）. KPS was significantly associated with RP of ≥grade 1（x2 =3.98 ,P = 0.046）and ≥grade 2（x2 = 5.21, P = 0.023）. In logistic multivariate analysis, diabetes was significantly associated with RP of ≥grade 1（x2 =5.50,P =0.019）and ≥grade 2（x2 = 12.92,P =0.000）. KPS was significantly associated with RP of ≥ grade 1（x2 = 6.29, P = 0.012）and ≥ grade 2（x2 = 6.61, P =0.010）. Conclusion The definite statistical significant risk factors of RP are diabetes and KPS.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2011年第1期23-26,共4页
Chinese Journal of Radiation Oncology
基金
基金项目：贵州省科学技术基金项目（黔科合J字[2008]2161）
贵州省科技厅社发攻关项目（黔科合s字[2008]1001、黔科合SY[2010]3078）
关键词
癌
非小细胞肺/同期放化疗法
放射疗法
三维适形
放射疗法
调强后程加速超分割
放射性肺炎
Carcinoma,non-small cell lung/concurrent radiochemotherapy
Radiotherapy, threedimensional conformal
Radiotherapy, intensity-modulated late-course accelered hyperfraction
Radiation paneumonitist
