【作者】 祝淑钗； 沈文斌； 王玉祥； 苏景伟； 李娟； 李任；

【Author】 ZhuShu-Chai Shen Wen-Bin Wang Yu-Xiang Su Jing-Wei Li Juan Li Ren Department of Radiation Oncology, the fourth hospital of Hebei medical university & Hebei provincial tumor hospital, Shijiazhuang, 050011, China

【机构】 河北医科大学第四医院暨河北省肿瘤医院放疗科；

【摘要】 目的:分析三维适形放疗食管癌患者的临床物理参数,为进一步优化食管癌适形放疗计划,减少放射性肺炎的发生提供参考标准。方法:回顾性总结55例食管癌患者的三维适形治疗计划及临床资料,并对相关因素进行单因素、多因素的统计分析。结果:55例中发生放射性肺炎12 例,其中2级9例,3级3例。与放射性肺炎相关的因素有二程放疗、总剂量、后半程射野数、总射野数、肺V10、肺 V15、肺V20、肺V25、肺Dmean、食管GTVV50。Logistic多元回归分析显示二程放疗、后半程射野数、肺V25为放射性肺炎发生的独立影响因素。结论:全程适形与后半程适形的照射方式对放射性肺炎的发生影响不大;二程放疗、后半程射野数、肺V25为放射性肺炎发生的主要影响因素;二程放疗应严格掌握适应症,并适当降低放疗剂量。更多还原

【Abstract】 Objective: To evaluate the clinical factors and physical parameters related to radiation-induced pneumonitis in oesophageal carcinoma treated with three-dimensional conformal radiotherapy (3D-CRT). Methods: From October 2000 to December 2003,55 esophageal carcinoma patients were retrospectively reviewed with clinical factors and physical parameters in relation to radiation-induced pneumonitis.Logistic regression model was used to test their relativities. Results: According to the RTOG criteria, pneumonitis was observed in 12 patients, the rate of incidence 21.8%,with 9 in grade II ,3 grade III. Secondary-course radiotherapy, total dose, the late-course irradiation beams,total irradiation beams, lungs V10, lungs V15,lungs V20,lungs V25 and lungs Dmean,and oesophageal GTVV50 Were significantly correlated with radiation-induced pneumonitis. Multilogistic regression analysis showed that Secondary-course radiotherapy,the late-course irradiation beams and lungs V25 were the independent inducing factors for pneumonitis. Radiation-induced pneumonitis had no significant effect on the survival of esophageal carcinoma. Conclusion: There are no significantly difference in the radiation-induced pneumonitis with the two model of total-course 3D-CRT and the late-course 3D-CRT, Secondary-course radiotherapy, the late-course irradiation beams and lungs V25 are significantly associated with the pneumonitis in oesophageal carcinoma patients treated with 3D-CRT, we should be cautious with the indication and the total dose of Second-ary-course radiotherapy for esophageal carcinoma patients.更多还原