You Position: Home > Paper
Risk factors for radiation pneumonitis in stage Ⅲ non-small-cell lung cancer treated with three-dimensional conformal radiotherapy
( views:512, downloads:266 )
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIATION ONCOLOGY
- Issue:
- 6
- DOI:
- 10.3760/j.issn:1004-4221.2007.06.004
- Key Word:
- 非小细胞肺癌/三维适形放射疗法;剂量体积直方图;放射性肺炎
Abstract： 目的 分析三维适形放疗(3DCRT)的ⅢA和ⅢB期非小细胞肺癌病例,分别评估≥2、3级放射性肺炎的发生与临床及剂量学参数的关系.方法 107例病理组织学证实的ⅢA、ⅢB期非小细胞肺癌接受了平均60(26～74)Gy的3DCRT,其中42例单纯放疗,65例序贯放化疗.记录各临床因素及剂量体积直方图(DVH)参数,观察放疗结束3个月内发生的≥2级放射性肺炎(RP)和≥3级的放射性肺炎(SRP).分级采用NCICTC3.0标准,统计用SPSS10.0软件包.结果 107例共发生放射性肺炎39例,其中2级26例,3级10例,5级3例,SRP标准的13例.对RP单因素分析显示MLD、IMLD、CMLD、IV20～IV35、CV10、CV15、CV40、CV50及V10～V35有统计学意义(P=0.004、0.009、0.047、0.010、0.008、0.014、0.031、0.022、0.016、0.023、0.026、0.048、0.006、0.002、0.027、0.032、0.043),多因素分析显示V20是惟一RP发生的预测因子(P=0.005).对SRP单因素分析显示MLD、IV20、IV25、IV30、CV5、CV10、Vi10、V15、V20、V30有统计学意义(P=0.005),多因素分析显示CV10是惟一SRP发生的预测因子(P=0.028).结论 对Ⅲ期非小细胞肺癌3DCRT,DVH参数与放射性肺炎的发生明显相关,其中V20、CV10分别是预测RP、SRP的剂量学指标.
- [1]王颖杰,王绿化,冯勤付,等.肺癌三维适形放射治疗中肺和食管损伤的相关因素分析[J].2005,(5).
- [2]Perez CA,Lockett MA,Bosch W,etc.Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC).[J].1999,45(2).
- [3]Falchero L,Hominal S,Claude L,etc.A prospective study on radiation pneumonitis following conformal radiation therapy in non-small-cell lung cancer: clinical and dosimetric factors analysis.[J].2004,71(2).
- [4]B, Emami,J, Lyman,A, Brown,etc.Tolerance of normal tissue to therapeutic irradiation.[J].1991,21.
- [5]Robnett TJ,Machtay M,Vines EF,etc.Factors predicting severe radiation pneumonitis in patients receiving definitive chemoradiation for lung cancer.[J].2000,48(1).
- [6]Huang H,Jirtle RL,Bentel G,etc.Predicting the risk of symptomatic radiation-induced lung injury using both the physical and biologic parameters V(30) and transforming growth factor beta.[J].2001,50(4).
- [7]Vicic M,Hope AJ,Deasy JO,etc.Modeling radiation pneumonitis risk with clinical, dosimetric, and spatial parameters.[J].2006,65(1).
- [8]Merrick S,Venkatraman E,Burman C,etc.Dose-volume factors contributing to the incidence of radiation pneumonitis in non-small-cell lung cancer patients treated with three-dimensional conformal radiation therapy.[J].2002,54(2).
- [9]Kotani Y,Satouchi M,Tsujino K,etc.Predictive value of dose-volume histogram parameters for predicting radiation pneumonitis after concurrent chemoradiation for lung cancer.[J].2003,55(1).
- [10]B, Singh,J E, Arrand,M C, Joiner.Hypersensitive response of normal human lung epithelial cells at low radiation doses.[J].1994,65.
- [11]M, Roach,D R, Gandara,H S, Yuo,etc.Radiation pneumonitis following combined modality therapy for lung cancer: analysis of prognostic factors.[J].1995,13.
- [12]Leibel SA,Braban L,Ling CC,etc.Correlation of dosimetric factors and radiation pneumonitis for non-small-cell lung cancer patients in a recently completed dose escalation study.[J].2005,63(3).
- [13]Wei X,Liu HH,Tucker SL,etc.Analysis of clinical and dosimetric factors associated with treatment-related pneumonitis (TRP) in patients with non-small-cell lung cancer (NSCLC) treated with concurrent chemotherapy and three-dimensional conformal radiotherapy (3D-CRT).[J].2006,66(5).
- [14]Wang S,Cox JD,Komaki R,etc.Initial evaluation of treatment-related pneumonitis in advanced-stage non-small-cell lung cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy.[J].2007,68(1).
- [15]Fay M,Fisher R,Mac Manus M,etc.Dose-volume histogram analysis as predictor of radiation pneumonitis in primary lung cancer patients treated with radiotherapy.[J].2005,61(5).
- [16]Rodrigues G,Lock M,D'Souza D,etc.Prediction of radiation pneumonitis by dose-volume histogram parameters in lung cancer-a systematic review.[J].2004,71(2).
- [17]Onishi H,Kuriyama K,Yamaguchi M,etc.Concurrent two-dimensional radiotherapy and weekly docetaxel in the treatment of stage III non-small cell lung cancer: a good local response but no good survival due to radiation pneumonitis.[J].2003,40(1).
- [18]Komaki R,Roa WH,Bosch W,etc.Toxicity and outcome results of RTOG 9311: a phase I-II dose-escalation study using three-dimensional conformal radiotherapy in patients with inoperable non-small-cell lung carcinoma.[J].2005,61(2).
- [19]Liao Z,Stevens C,Gopal R,etc.The relationship between local dose and loss of function for irradiated lung.[J].2003,56(1).