乳腺癌术后三维适形放疗致放射性肺炎相关因素分析

Relative factors analysis on the radiation pneumonitis caused by three-dimensional conformal radiation therapy after breast cancer operation

目的探讨乳腺癌三维适形放疗致放射性肺炎的相关因素。方法选取2012年7～12月于我院采用三维适形放疗的49例乳腺癌患者，采用影像学等手段，回顾性分析了患者的年龄、三维适形放疗照射剂量、照射野面积、治疗方案等因素与放射性肺炎发生率间的关系。结果〉60岁的患者中出现放射性肺炎的发生几率为35．29％，而≤60岁的患者为18．75％；受照剂量大于50Gy后，患者的发生几率为76．92％，受照剂量小的患者为33．33％；照射野面积〉120cm2的患者放射性肺炎的发生几率为12．12％，照射野面积小的患者为6．25％。联合放疗后的发生几率为33．33％，显著高于非联合放疗15．79％的发生率。经统计学分析，差异均有统计学意义（P〈0．05）。结论患者年龄、照射剂量、照射野面积和联合化疗与否等因素和患者放射性肺炎的发生具有密切的相关性。

Objective To explore the relevant factors of the radiation pneumonitis caused by three dimensional conformal radiation therapy of breast cancer. Methods 49 breast cancer patients who took the three-dimensional conformal radiation therapy at our hospital in July 2012 to December 2012 had been selected, and the iconography and other methods had been used. The retrospective analysis had been conducted on the relationship between the age of patient, exposure dose of three-dimensional conformal radiation therapy, the area of radiation field, therapeutic regimen and other factors with the occurrence rate of the radiation pneumonitis. Results In the patients elder than 60 old years, the occurrence rate of the radiation pneumonitis was 35.29%, but in the patients younger than 60 years old, the occurrence rate was 18.75%. After the exposure dose was larger than 50Gy, the occurrence rate in the patients was 76.92%. The patient with less exposure dose was 33.33%. The occurrence rate of the radiation pneumonitis of the patients with the area of radiation field larger than 120cm2 was 12.12% while the patients with less area of radiation field was 6.25%. The occurrence rate after combing the postradiotherapy was 33.33%, which was remarkably higher than the occurrence rate of non-combined chemotherapy 15.79%. Through the analysis of the statistics, there was significance of difference（P 〈 0.05）. Conclusion There is close relevancy between the age of patient, exposure dose, the area of radiation field and whether or not getting the combined chemotherapy with the occurrence rate of the radiation pneumonitis of the patient.