高原地区肺癌患者放疗后发生放射性肺损伤的危险因素

Analysis of risk factors of radioactive- induced lung injury in patients with lung cancer in plateau area

目的:探讨影响高原肺癌患者发生放射性肺损伤的危险因素。方法:采用回顾性病例对照研究分析我院183例肺癌患者接受放射治疗后发生RILI的危险因素。运用单因素χ2检验和多因素Logistic回归分析独立影响因素,Kaplan-Meier分析比较两组患者的生存情况及血液毒性变化。结果:经单因素分析发现民族、常住地、合并慢性肺炎、合并慢性病和V20有统计学意义(χ2=8.548、40.539、6.941、8.117、41.79,P<0.05)。多因素分析发现民族、常住地、合并慢性肺炎和V20是独立的危险因素(P<0.05)。放疗开始对患者的血液变化影响较大,尤其是 WBC 等。生存分析显示对照组中位生存期 16 个月明显高于病例组 11 个月( P< 0. 05) 。结论: 影响患者发生 RILI 因素很多,应该根据患者基本情况适当调整放射治疗方案,以降低 RILI的发病风险。的血液变化影响较大,尤其是WBC等。生存分析显示对照组中位生存期16个月明显高于病例组11个月(P<0.05)。结论:影响患者发生RILI因素很多,应该根据患者基本情况适当调整放射治疗方案,以降低RILI的发病风险。

Objective：To investigate the risk factors related to lung cancer of radiation -induced lung injury （RI- Ll） in plateau area. Methods：Analyzing the risk factors of RILl of 183 lung cancer patients with receiving radiotherapy by retrospective case - control study, to seek independent influencing factors by using single factor x^2 test and multiple factors Logistic analysis and Kaplan - Meier. Results：Single factor analysis found that there were statistically significant with national,local living, merging chronic pneumonia, chronic disease and V20 （ x^2 = 8.55,40.54,6.94, 8.12,41.79 ,P 〈 0.05）. Multiple factor Logistic analysis found that the independent risk factors were national, local living, merging chronic pneumonia and V20 （P 〈 0.05 ）. Radiation therapy was contributed to blood changes greatly, especially WBC. Smwival analysis showed that the median survival time with 16 months of control group has statistical- ly significantly better than 11 months of case group （ P 〈 0.05 ）. Conclusion： There were many influencing factors of RILl, and radiation treatment plan should be adjusted according to the basic situation of lung cancer patients, in order to reduce the risk of RILl.