NSCLC合并2型糖尿病放疗发生放射性肺炎的临床病理因素分析

Analysis of clinicopathological factors of radiation pneumonia in NSCLC with type 2 diabetes mellitus

目的探讨非小细胞肺癌(NSCLC)合并2型糖尿病(T2DM)患者放疗发生放射性肺炎的临床病理因素。方法收集四川省肿瘤医院2010年9月-2018年12月开展放射治疗的NSCLC合并T2DM患者80例资料(观察组),并收集同期开展放疗的单纯NSCLC患者421例(对照组)。比较两组年龄、性别、体重指数、高血压史、原发性肿瘤分期(T分期)、淋巴结转移分期、TNM分期、远端转移、病理类型等资料,记录放射性肺炎发生率。结果观察组年龄、合并高血压率均明显高于对照组,差异有统计学意义(P<0.05);而两组性别、体重指数、病理类型、TNM分期、T分期、远端转移、淋巴结转移、照射面积、同步化疗情况比较差异均无统计学意义(P>0.05)。观察组放射性肺炎发生率明显高于对照组(46.25%vs.19.71%),差异有统计学意义(P<0.05)。将80例NSCLC合并T2DM患者按照血糖控制水平及病程分组比较,其中空腹血糖≥7.0 mmol/L患者放射性肺炎发生率明显高于空腹血糖<7.0 mmol/L患者(70.37%vs.33.96%),差异有统计学意义(P<0.05);T2DM病程≥5年患者放射性肺炎发生率明显高于病程<5年患者(61.76%vs.34.78%),差异有统计学意义(P<0.05)。结论T2DM是NSCLC患者放疗并发放射性肺炎的高危因素,对此需结合糖尿病易感因素,加强血糖管理,制定合理放疗方案,减少放射性肺炎的发生。

Objective To explore the clinicopathological factors of radiation pneumonia in patients with non-small cell lung cancer(NSCLC)with type 2 diabetes mellitus(T2DM).Methods A total of 80 patients with NSCLC combined with T2DM who underwent radiotherapy from September 2010 to December 2018 in Sichuan Cancer Hospital were collected(observation group),and 421 patients with simple NSCLC who underwent radiotherapy during the same period(control group)were collected.The age,gender,body mass index,history of hypertension,primary tumor stage(T stage),lymph node metastasis stage,TNM stage,distant metastasis,and pathological type were statistically compared between the two groups to record the incidence of radiation pneumonia.Results The age of the observation group and the incidence of combined hypertension were significantly higher than those of the control group(P<0.05),and the sex,body mass index,pathological type,TNM stage,T stage,distal metastasis,lymph node metastasis,irradiation area and synchronous chemotherapy were not statistically significant in the two groups(P>0.05).The incidence of radiopneumonia in the observation group was significantly higher than that in the control group(46.25%vs.19.71%)(P<0.05).80 patients with NSCLC with T2DM were compared according to the level of blood glucose control and course of disease,in which the incidence of radiation pneumonia in patients with fasting blood glucose≥7.0 mmol/L was significantly higher than that in patients with fasting blood glucose<7.0 mmol/L(70.37%vs.33.96%)(P<0.05);the incidence of radiation pneumonia in patients with T2DM duration≥5 years was significantly higher than that of patients with duration<5 years(61.76%vs.34.78%),and the difference was statistically significant(P<0.05).Conclusion T2DM was a high-risk factor for radiation pneumonia in NSCLC patients treated with radiotherapy.For this,it was necessary to combine diabetes susceptibility factors and strengthen blood sugar management for the formulation of a reasonable radiotherapy plan to prevent and control radiation pneumonia.