胃癌放疗患者肾毒性分析

发布时间：2018-02-03 02:24

本文关键词： 胃癌放射治疗肾毒性调强放疗　出处：《苏州大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的通过对胃癌患者放疗情况及肾脏受照剂量进行回顾性分析,并结合放疗前后肾功能评价,探讨胃癌患者在接受放射治疗时对肾脏的影响。方法收集了我院自2014年7月至2015年6月全部接受过放射治疗的胃恶性肿瘤患者的病历及放疗病案,提取了放疗方案及肾脏剂量等数据及血液、尿液生化检查结果。采用回顾性研究,通过SPSS 22.0软件,利用配对t检验、独立样本t检验、方差分析等统计学方法对符合条件的40例病例进行剂量学相关的回顾性分析,同时结合了部分患者放疗前和一段时间后随访时的肾小球滤过率(MDRD法),以p0.05为有统计学意义。结果右肾最大剂量较靶区处方剂量低,而左肾最大剂量与靶区处方剂量间没有显著的统计学差异。左肾平均剂量高于右肾平均剂量,双侧肾脏的平均受照剂量均远小于靶区处方剂量及肾脏的TD5/5。5野IMRT的病例右肾最大受照剂量较接受6野IMRT的病例的右肾最大受照剂量低。21例随访记录中包括肾功能相关的实验室检查结果的病人,中位随访期6个月(3-9个月),其放疗后至末次随访期间均没有发现明显的蛋白尿等,放疗前与放疗后的肾小球滤过率(MDRD法)两者间没有显著的统计学意义。结论采用调强放射治疗技术,在胃癌放疗中可以很好地保护离肿瘤靶区最近的正常组织器官——肾脏。
[Abstract]:Objective to evaluate the renal function of patients with gastric cancer before and after radiotherapy by retrospective analysis of radiotherapy and renal radiation dose. To investigate the effect of radiotherapy on the kidney of patients with gastric cancer. Methods from July 2014 to June 2015, we collected the medical records of all patients with gastric malignant tumors who received radiotherapy in our hospital. The data of radiotherapy regimen, renal dose, blood and urine biochemical examination were extracted. By retrospective study, SPSS 22.0 software, paired t test and independent sample t test were used. Statistical methods such as analysis of variance were used for dosis-related retrospective analysis of 40 eligible cases. At the same time, the glomerular filtration rate (GFR) of some patients before and after a period of follow-up was compared with MDRD method, p0.05 was statistically significant. Results the maximum dose of right kidney was lower than that of prescription in target area. There was no significant difference between the maximum dose of left kidney and the prescription dose of target area. The average dose of left kidney was higher than that of right kidney. The average exposure dose of bilateral kidneys was significantly lower than that of the target area prescription dose and the TD5/5.5 field IMRT of the kidney. The maximum dose of the right kidney was lower than that of the patients with 6 field IMRT. .21 patients whose follow-up records included results of laboratory tests related to renal function. The median follow-up period was 3 to 9 months, and no significant proteinuria was found from radiotherapy to the last follow-up. There was no significant difference between pre-radiotherapy and post-radiotherapy glomerular filtration rate (MDRD). Conclusion intensity modulated radiotherapy is used. It can protect the kidney, which is the nearest normal tissue organ from tumor target area, in gastric cancer radiotherapy.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.2

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