局部晚期非小细胞肺癌放疗后放射性肺炎危险因素分析

Analysis of Related Factors of Radiation Pneumonitis in Locally Advanced NSCLC Patients Treated with Radiotherapy

目的探讨局部晚期非小细胞肺癌(non-small cell lung carcinoma,NSCLC)放疗后发生放射性肺炎(radiation pneumonitis,RP)的相关因素。方法选取85例局部晚期NSCLC患者为研究对象。所有患者均无手术切除指征,采用三维适形或调强放射治疗。单因素及多因素Logistic回归分析性别,年龄,慢性阻塞性肺疾病(COPD),肿瘤位置,分期,同期放化疗,化疗周期,放疗总剂量,MLD以及V5、V20对RP的影响。结果 25例患者(29.4%)出现RP。单因素分析结果显示放疗前合并COPD、放疗前化疗周期、同期放化疗、MLD、V5、V20与放射性肺炎有关(P<0.05)。多因素Logistic回归分析发现放疗前合并COPD、放疗前化疗周期、同期放化疗、V20以及MLD是RP发生的独立危险因素(P<0.05)。结论局部晚期非小细胞肺癌放疗计划应考虑患者的临床、个体因素,设定合理的放疗参数,从而降低放射性肺炎的发生率。

Objective To analyze the related factors of radiation pneumonitis in locally advanced NSCLC patients treated with radiotherapy .Methods 85 unresectable locally advanced NSCLC patients were selected ,all the patients received three-di-mensional conformal radiation therapy （3DCRT） or intensity modulated radiation therapy （ IMRT）.The relationship of radiation pneumonitis and sex,age,COPD,pathologic type,lesion location,staging,concurrent chemotherapy,chemotherapy volume,MLD, V5,V20 was analyzed by single factor analysis and multiple factors analysis .Results 25（29.4%）patients had radiation pneu-monitis（RP）.Single factor analysis showed that COPD,the cycles of pre-chemotherapy,concurrent chemotherapy,MLD,V5,V20 were correlated with radiation pneumonitis .Multiple factors analysis showed that COPD , cycles of pre-chemotherapy , concurrent chemotherapy,V20 and MLD were independent risk factors for radiation pneumonitis （P〈0.05）.Conclusion For locally ad-vanced NSCLC patients ,clinical and individual factors should be taken into account to set a reasonable radiotherapy plan ,and it can decrease incidence rate of radiation pneumonitis .