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Predictors of radiation-induced lung toxicities in patients with thoracic middle and lower esophageal cancer treated with three-dimensional conformal radiotherapy
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIATION ONCOLOGY
- Issue:
- 5
- DOI:
- 10.3760/j.issn:1004-4221.2007.05.004
- Key Word:
- 食管肿瘤/三维适形放射疗法;放射性肺损伤;因素分析
Abstract： 目的 分析胸中下段食管癌患者三维适形放疗后导致放射性肺损伤的临床、物理因素.方法 选取56例接受根治性放疗的食管癌患者密切随访.以患者临床症状、胸部X线片、CT、薄层CT了解患者有无急性放射性肺炎及晚期放射性肺损伤发生,对患者临床资料和治疗计划等指标进行单因素及多因素分析,评价放射性肺损伤.结果 单因素分析显示X线片食管病变长度、处方剂量、肺V5～V25、肺Dmean、食管PTVD90、食管PTVV50及总射野数等11个因素与急性放射性肺炎发生相关,且其数值在有无发生急性放射性肺炎两组中有差异;X线片食管病变长度、肺V5～V40肺Dmean及合并化疗与晚期放射性肺损伤相关,且其数值在有无发生晚期肺损伤的两组患者中亦有差异.Logistic多元回归分析显示肺V25、总射野数和X线片病变长度为急性放射性肺炎发生的独立影响因素,而肺V30和合并化疗为晚期放射性肺损伤发生的独立影响因素.急性放射性肺炎与晚期放射性肺损伤发生未见明显相关性.急性放射性肺炎、晚期放射性肺损伤对近期生存率未见明显影响.结论 食管癌患者肺V25总射野数及X线片食管病变长度可预测急性放射性肺炎的发生,肺V30和合并化疗为影响晚期放射性肺损伤发生的主要因素.
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