中晚期食管癌同步放化疗所致急性肺损伤发生因素分析

Risk factors of acute pneumonitis caused by synchronous chemoradiation in pantients with ad- vanced esophageal carcinoma

目的观察三维适形放疗联合同期化疗治疗中晚期食管癌时急性放射性肺损伤的发生情况，并对临床及剂量学因素进行分析。方法43例中晚期食管癌患者接受同期放化疗。放疗剂量5600～6000cGy，共28～30次，同期化疗3个疗程，分析急性放射性肺损伤的发生情况。结果临床因素中化疗周期数、肿瘤靶体积（GTV）、临床靶体积（nV）、肺功能状况、照射野个数均与放射性肺炎有关；剂量学因素中受照500cGy的靶体积占总体积的比例（V5）与受照2000cGy的靶体积占总体积的比例（V20）是影响严重放射性肺炎预后的因素。结论食管癌同期治疗中肺损伤的发生受多因素影响，剂量体积参数v5和V20与放射性肺损伤有关。

Objective To investigate the factors associated with radiation-induced lung damage in advanced esophageal carcinoma who underwent three dimensional conformal radiotherapy （3D-CRT） combined with chemotherapy. Methods 43 patients were treated with 3D-CRT combined with concurrent chemotherapy. The patients received chemotherapy in a dose of 5600 N 6000 cGy for three courses of treat- ment. The associated radiation-induced lung damage and its correlated factors were analyzed. Restlits The chemotherapy periodicity ,tumor and clinical target volume, pulmonary function and the total irradia- tion fields were significantly correlated with the radiation-induced lung damage, V5 and V20 were risk fac- tors which affected the prognosis of serious radiation pneumonitis. Conclusion Some factors may contrib- ute to radiation-induced lung damage in esophageal carcinoma, the dose-volume parameters of V5 and V20 are correlated with the radiation-induced lung damage.