肺癌患者容积旋转调强放疗放射性肺炎发生的影响因素分析

Analysis of the influencing factors of radiation pneumonitis in patients with lung cancer

目的:探讨肺癌患者容积旋转调强放疗(VMAT)放射性肺炎(RP)发生的影响因素。方法:选择2018年8月—2019年8月行VMAT的肺癌患者72例,收集所有患者一般资料及剂量学参数信息,记录RP发生率,与无RP对比差异性,并分析行VMAT的肺癌患者RP发生的影响因素。结果:RP发生率为25.00%;RP发生在年龄、糖尿病和双肺V5,V20,V30及双肺平均剂量(MLD)方面与无RP比较,差异有统计学意义(P<0.05)。经Logistic回归分析,年龄大、糖尿病、MLD高和双肺V5,V20,V30高是行VMAT的肺癌患者RP发生的危险因素(OR>1,P<0.05)。结论:行VMAT的肺癌患者RP发生的危险因素为年龄大、糖尿病、MLD高和双肺V5,V20,V30高,临床需严格控制低剂量区体积,以减少RP发生。

Objective:To explore the influencing factors of radiation pneumonitis(RP)in lung cancer patients treated with volumetric modulated arc therapy(VMAT).Methods:The clinical data of 72 lung cancer patients with VMAT from August 2018 to August 2019 in our hospital were collected,the general data and dosimetric parameters of all patients were collected,the incidence of RP was recorded,and the differences were compared with those without RP,and the influencing factors of RP in lung cancer patients with VMAT were analyzed.Results:The incidence of RP was 25.00%,and the difference between RP and no RP was statistically significant(P<0.05)in age,diabetes,dual lung V5,V20,V30 and dual lung mean dose(MLD).By logistic regression analysis,old age,diabetes,high MLD and high dual lung V5,V20 and V30 were the risk factors of RP in lung cancer patients with VMAT(OR>1,P<0.05).Conclusion:The risk factors of RP in lung cancer patients with VMAT are old age,diabetes and high MLD,double lung V5,V20 and V30.It is necessary to strictly control the volume of low dose area in order to reduce RP.