乳腺癌根治术后放疗联合胸腺五肽预防放射性肺损伤的临床研究

Clinical analysis of postoperative radiotherapy for breast cancer combined with thymopentin-5 on the prevention of radiation-induced lung injury

目的分析放射性肺损伤发生的相关因素,评价乳腺癌术后放疗联合胸腺五肽预防放射性肺损伤的临床疗效。方法回顾分析97例乳腺癌根治术后辅助性放疗患者的临床资料,包括年龄、化疗周期数、化疗药物、是否合并糖尿病及慢性阻塞性肺疾病（COPD）等;按治疗方法将患者分为2组,单纯放疗（RT）组32例,放疗联合胸腺五肽（RT＋TP-5）组65例,分析2组患者从放疗开始至放疗结束后4-16周的胸部CT影像学变化,比较2组放射性肺损伤的发病率以及相关的影响因素。结果 RT组放射性肺损伤发病率为44%,RT＋TP-5组放射性肺损伤发病率为34%,2组比较无显著性差异（P〉0.05）。2组各年龄层发病率比较均无显著性差异（P均〉0.05）。行≤4周期化疗后放射性肺损伤发病率RT组为16%,TR＋TP-5组为23%,2组比较无显著性差异（P〉0.05）;行〉4周期化疗后放射性肺损伤发病率RT组为85%,TR＋TP-5组为47%,2组比较有显著性差异（P〈0.05）。2组行≤4周期化疗后放射性肺损伤发病率与〉4周期比较均有显著性差异（P均〈0.05）。是否合并糖尿病RT组放射性肺损伤发病率分别为45%和43%,TR＋TP-5组分别为39%和32%,2组比较均无显著性差异（P均〉0.05）。结论乳腺癌根治术后行辅助放疗的患者全身化疗增加了放射性肺损伤的发病风险,且化疗周期越长,其发病风险越高。化疗方案、是否合并糖尿病与放射性肺损伤的发生无明显相关性。乳腺癌根治术后放疗同时应用TP-5可降低放射性肺损伤发生风险。

Objective It is to analyze the related factors of radiation-induced lung injury , and evaluate the clinical efficacy of postoperative radiotherapy for breast cancer combined with Thymopentin -5 on the prevention of radiation -induced lung injury.Methods The clinical data of 97 patients with postoperative radiotherapy for breast cancer were retrospective analyzed , including age , chemotherapy cycle , chemotherapeutics , with or with out diabetes , chronic obstructive pulmonary disease （ COPD） , etc.The patients were divided into 2 groups according to treatment methods , there were 32 cases in radiotherapy （RT） group, and 65 cases in radiotherapy combined with Thymopentin -5 （RT＋TP-5） group.The image changes of two groups of patients CT from the beginning of the radiotherapy until 4 to 6 weeks after radiotherapy were analyzed .The morbidity and the relevant factors of two groups were compared .Results The morbidity was 44%in RT group and 34%in RT＋TP-5 group, there was no significant difference between them （P〉0.05）.There were no significant differences between the onset of age level with two groups （P〉0.05）.For the group that have cycle of chemotherapy≤4, the rates of radiation-induced lung injury in RT group was 16%and 23% in TR＋TP-5 group, there was no significant difference （P〉0.05）, For the group that have cycle of chemotherapy 〉4, the rates of radiation-induced lung injury in RT group was 85%and 47%in TR＋TP-5 group, there was significant difference between them （P〈0.05）.There was no significant difference in the rates of radiation-induced lung injury between chemotherapy cycle in≤4 period and 〉4 period for both groups （all P〈0.05）.About whether with diabetes or not , the incidence of radiation -induced lung injury rates of RT group were 45%, 43%, while the rates of TR＋TP-5 group were 39%, 32%, but there was no significant difference between both groups （P〉0.05）.Conclusion For the patient with radiotherapy after radical operation of breast cancer , systemic chemotherapy can increased the risk of radiation-induced lung injury , and the chemotherapy cycle is longer , the risk of radiation-induced lung injury is higher . There are no significant correlation in chemotherapeutics , with or with out diabetes with radiation-induced lung injury .Postop-erative radiotherapy for breast cancer combined with TP -5 can decrease the risk of radiationinduced lung injury .