乳腺癌保乳术后三维适形放疗致急性放射性肺损伤的相关因素分析

Risk factors of acute lung injury induced by three-dimensional conformal radiotherapy in patients with breast cancer after breast-conserving surgery

目的分析乳腺癌患者保乳术后i维适形放疗致急性放射性肺损伤的危险因素。方法收集2014年1～12月在本院行乳腺癌保乳术后接受i维适形放疗的86例患者临床资料，采用单因素及多因素logistic回归分析致急性放射性肺损伤的相关因素。结果急性放射性肺损伤发生率为10．47％（9／86）。单因素分析最示，照射野、患侧肺平均照射剂量及患侧肺V5、V10、V15、V20,V25与急性放射性肺损伤的发生有关（P〈O．05），多因素logistic回归分析显示V20是影响急性放射性肺损伤的独立危险因素（P〈O．001）。结论患侧肺V20是乳腺癌患者保乳术后行三维适形放疗致急性放射性肺损伤的独立危险因素。

Objective To identify risk factors for acute lung injury induced by three-dimensional contormal radiotherapy （3DCRT） in patients with breast cancer after breast-conserving surgery. Methods A total of 86 breast cancer patients who received 3DCRT after breast-conserving surgery were retrospectively analyzed. Univariate and muhivariate analyses were conducted to identify risk factors associated with acute radiation-induced lung injury. Results 9 patients （10.47%） experienced acute radiation- induced lung injury. Univariate analysis identified the following risk factors： radiation fields, ipsilateral lung V5, V10,V15, V20, V25 and average amount of ipsilateral lung （P〈0.05）. Multivariate analysis identified ipsilateral lung V20 as an independent risk factor for acute radiation-induced lung injury （P〈0.001）. Conclusion Ipsilateral lung V20 is an independent risk factor for acute lung injury induced by 3DCRT in patients with breast cancer after breast-conserving surgery.