不同分级放射性肺炎的临床特征及其影响因素

发布时间：2018-01-29 18:17

本文关键词： 放射性肺炎胸部肿瘤放射治疗临床特征影响因素　出处：《山东医药》2017年33期 　论文类型：期刊论文

【摘要】：目的探讨不同分级放射性肺炎(RP)的临床特征及影响因素。方法按照全美肿瘤放射治疗协作组RP评价标准,选取放疗后3个月内发生RP患者50例,其中RP 2级16例,3级22例,≥4级12例。比较不同分级RP患者临床特征、治疗模式、剂量学相关指标的差异。结果临床特征方面,不同分级RP患者放疗前KPS评分、临床分期以及放疗后免疫功能状态差异均有统计学意义(P均0.05);治疗模式方面,不同分级RP患者照射剂量、诱导化疗周期、是否合并靶向治疗、RP出现时间、影像学渗出范围比较有统计学差异(P均0.05);放射剂量学方面,不同分级RP患者肿瘤体积(GTV)、患肺体积、GTV剂量、计划靶体积、双肺V20、双肺V25、双肺V30、患肺V5、患肺V10、患肺V20、患肺V25、患肺V30差异均有统计学意义(P均0.05)。结论 RP严重程度分级与患者临床特征、治疗模式、放射剂量有关,GTV和双肺受照射体积是影响RP严重程度的主要剂量学指标。
[Abstract]:Objective to investigate the clinical characteristics and influencing factors of RPs in different stages of radiation pneumonitis. Methods 50 patients with RP within 3 months after radiotherapy were selected according to the evaluation criteria of RP in the tumor radiotherapy cooperation group. There were 22 cases of grade 3 and 22 cases of grade 3 of grade RP2 and 12 cases of grade 4. The differences of clinical features, treatment modes and dosimetry were compared among the patients with different grades of RP. Results the clinical features were analyzed. There were significant differences in KPS score, clinical stage and immune function status in patients with different grades of RP before radiotherapy (P < 0.05). In terms of treatment mode, there were significant differences in radiation dose, induced chemotherapy period, time of occurrence of RP with target therapy and imaging exudation range in patients with different grades of RP (P < 0.05). In terms of radiation dosimetry, the tumor volume of patients with different grades of RP was GTV, GTV dose of lung volume, planned target volume, double lung V20, double lung V25, double lung V30, and lung V5. There were significant differences in lung V10, lung V20, lung V25 and lung V30 between two groups (P < 0.05). Conclusion the severity of RP is related to the clinical characteristics and treatment mode of patients. Radiation dose dependent GTV and lung exposure volume were the main dosimetric indexes to influence the severity of RP.
【作者单位】：兰州大学第一临床医学院;甘肃省肿瘤医院;
【基金】：甘肃省科技厅青年科技基金计划(145RJYA275) 甘肃省卫生行业科研计划(GSWSKY-2015-35)
【分类号】：R730.55
【正文快照】： 放射性肺炎(RP)是肺癌及其他胸部肿瘤放疗的常见并发症,其严重程度对患者预后有重要影响,严重RP患者往往出现不可逆肺功能改变,甚至危及生命。如何降低RP发生率,特别是降低高分级RP的发生率,对于提高肺癌及其他胸部恶性肿瘤的疗效、改善患者生活质量、延长生存期具有重要的意

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