非小细胞肺癌患者手术放疗后放射性肺损伤发生率和影响因素研究

Study on the Incidence and influencing Factors of Radiationinduced Lung Injury in non-small-cell Lung Carcinoma Patients after Surgery and Radiotherapy

目的分析非小细胞肺癌患者手术放疗后放射性肺损伤发生率和影响因素。方法选择2017年5月—2018年5月间在湖南中医药大学附属宁乡医院进行非小细胞肺癌手术治疗及放射治疗的82例患者为研究样本,回顾性分析全部患者临床资料,观察出现放射性肺损伤和未出现放射性肺损伤患者临床资料。采用Logistic回归方程分析非小细胞肺癌患者手术及放射治疗后放射性肺损伤发生率及影响因素。结果82例患者均实施放射治疗,放射治疗结束时有7例(8.54%)患者出现放射性肺损伤,放射治疗结束6个月时有23例(28.05%)患者出现放射性肺损伤;82例患者中,有59例患者评估为0级,10例患者评估为1级,8例患者评估为2级,5例患者评估为3级。出现放射性肺损伤患者与未出现放射性肺损伤患者在治疗方式及放射剂量方面差异存在统计学意义(P<0.05);将治疗方式及放射剂量带入Logistic回归方程计算可知:同步治疗及放射剂量>40是非小细胞肺癌患者手术治疗及放射治疗后出现放射性肺损伤的影响因素。结论非小细胞肺癌患者手术及放射治疗后出现放射性肺损伤发生率较高,为降低放射性肺损伤发生率,临床医师需为患者制定针对性的治疗方案,同时合理控制放射剂量,减轻放射治疗对患者肺功能的损害,促进患者机体健康,提升其满意度。

Objective To analyze the incidence and risk factors of radiation-induced lung injury in patients with nonsmall-cell lung carcinoma after surgery and radiotherapy.Methods A total of 82 patients undergoing non-small-cell lung carcinoma surgery and radiotherapy in Hunan University of Traditional Chinese Medicine Affiliated Ningxiang County Hospital from May 2017 to May 2018 were selected as study samples,the clinical data of patients with and without radiation lung injury were observed.Logistic regression equation was used to analyze the incidence and risk factors of radiation-induced lung injury in non-small-cell lung carcinoma patients after surgery and radiotherapy.Results All the 82 patients were treated with radiotherapy.7(8.54%)patients had radiation lung injury at the end of radiotherapy and 23(28.05%)patients had radiation lung injury at the end of 6 months of radiotherapy,there were 59 patients with grade 0,10 with grade 1,8 with grade 2,and 5 with grade 3.There was significant difference in treatment and radiation dose between patients with radiation lung injury and those without radiation lung injury(P<0.05).According to logistic regression equation,synchronous therapy and radiation dose>40 were the risk factors of radiation lung injury in patients with non-small-cell lung carcinoma after surgery and radiotherapy.Conclusion The incidence of radiation-induced lung injury is high in patients with non-small-cell lung carcinoma after surgery and radiotherapy,in order to reduce the incidence of radiation-induced lung injury,clinicians should make specific treatment plan for patients,at the same time,the radiation dose should be reasonably controlled to reduce the damage of lung function,promote the health of patients and improve their satisfaction.