食管癌放疗致放射性肺损伤的高危因素分析与预防策略探讨

Analysis of high-risk factors of radiation-induced lung injury caused by radiotherapy for esophageal cancer and discussion of prevention strategies

目的分析食管癌放疗致放射性肺损伤的高危因素,探讨预防策略。方法选择2017年4月至2019年4月我院100例食管癌放疗患者为研究对象,根据有无放射性肺损伤分为观察组(无肺损伤)与对照组(有肺损伤)。收集患者年龄、合并疾病、肿瘤分期等病例资料并进行统计学处理,确定食管癌放疗致放射性肺损伤的高危因素。结果本组患者中有28例发生放射性肺损伤。两组患者卡氏评分(KPS)、肿瘤分期、是否合并肺部疾病、是否合并糖尿病、有无营养不良、年龄、有无吸烟史、有无同步化疗比较差异具有统计学意义(P<0.05)。多因素logistic回归分析显示,<KPS评分60~80分、肿瘤分期Ⅳ期、合并肺部疾病、合并糖尿病、营养不良是食管癌放疗致放射性肺损伤的高危因素(P<0.05)。结论食管癌放疗患者易发生放射性肺损伤,可根据KPS评分、肿瘤分期、合并肺部疾病等高危因素制定针对性预防策略,以降低其发生。

Objective To analyze the high-risk factors of radiation-induced lung injury caused by radiotherapy for esophageal cancer,and discussion of prevention strategies.Methods To select 100 cases of patients with esophageal cancer radiotherapy in our hospital from April 2017 to April 2019 as the study objects,and they were divided into an observation group(without lung injury)and a control group(with lung injury)according to the presence or absence of radiation-induced lung injury.The patient's age,combined diseases,tumor stage and other case data were collected and performed statistical processing to determine the high risk factors of radiation-induced lung injury caused by radiotherapy for esophageal cancer.Results There were 28 patients with radiation-induced lung injury in this group.There were statistically significance in the comparative differences among Karnofsky performance status(KPS),tumor stage,whether it had combined lung disease,whether it had combined diabetes,with or without malnutrition,age,with or without smoking history,and with or without concurrent chemotherapy of the two groups(P<0.05).Multivariate logistic regression analysis showed that the<KPS score was 60-80 points,tumor stage IV,combined lung disease,combined diabetes,malnutrition were the high risk factors for radiation-induced lung injury caused by radiotherapy for esophageal cancer(P<0.05).Conclusion The patients with esophageal cancer radiotherapy were prone to radiation-induced lung injury.According to high-risk factors such as KPS score,tumor stage,and combined lung disease,etc.targeted prevention strategies should be developed to reduce the occurrence.