肺癌放疗后放射性肺损伤CT分级与正常组织并发症概率的关系

Relationship of computed tomography grade of radiation-induced lung injury and normal tissue complication probability for the patients with non-small cell lung cancer treated by three-dimensional conformal radiotherapy

目的探讨非小细胞肺癌（NSCLC）三维适形放疗（3DCRT）后放射性肺损伤的CT分级与正常组织并发症概率（NTCP）的关系。方法将3DCRT治疗后CT随访6个月以上的169例Ⅰ-Ⅲ期NSCLC患者按随访CT放射性肺损伤的表现分级并分为CT阳性组（2—4级）和CT阴性组（0、1级），复习全部病例的治疗计划，按全肺NTCP和患侧肺的NTCP分布各分为5组，对比分析放射性肺损伤CT分级与NTCP的关系。结果不同CT分级的全肺和患侧肺NTCP值差异有统计学意义（全肺P=0．004，患侧肺P=0．000）；全肺NTCP分组和患侧肺NTCP分组研究均显示患侧肺CT分级阳性率组间差异有统计学意义（全肺P=0．003，患侧肺P=0．000）。结论NSCLC行3DCRT后放射性肺损伤的CT分级与NTCP密切相关。

Objective To explore the relationship of computed tomography （CT） grade of radiation-induced lung injury and normal tissue complication probability （NTCP） for the patients with non-small cell lung cancer treated by three-dimensional conformal radiotherapy （3D-CRT）. Methods One hundred and sixty-nine patients with stage Ⅰ-Ⅲ of non-small cell lung cancer treated by 3D-CRT and followed up more than 6 months by CT scan after 3D-CRT were divided into CT positive group （grades 2-4） and CT negative group （grades 0, 1 ）. The related physical parameters of the three-dimensional treatment planning for the patients were reviewed and the patients were divided into five groups according to NTCP values of the whole lung and the ipsilateral lung. The relationship of NTCP value and CT grade of radiation-induced lung injury were reviewed. Results There was significant difference between the NTCP values of the whole lung group according to the CT grades of radiation-induced lung injury, as well as the ipsilateral lung group, （for whole lung, P = 0.004; for ipsilateral lung, P = 0.000）. And there were significant difference of the positive rate of CT grade of lung injury between the different NTCP value groups （for whole lung, P = 0.003; for ipsilateral lung, P = 0.000）. Conclusions There is a close corelation between NTCP value and CT grade of radiation-induced lung injury for patients with NSCLC treated by 3D-CRT.