老年食管癌患者三维适形放疗后发生放射性肺炎与剂量体积参数的相关性

汪盛; 王彩莲; 范丽华

doi:10.3971/j.issn.1000-8578.2021.20.1323

老年食管癌患者三维适形放疗后发生放射性肺炎与剂量体积参数的相关性

Correlation Between Dose Volume Parameters and Radiation Pneumonitis in Elderly Patients with Esophageal Cancer After Three-dimensional Conformal Radiotherapy

摘要

摘要:
目的分析剂量体积参数与老年食管癌患者三维适形放疗后发生≥2级放射性肺炎的相关性。
方法收集并分析250例来自不同医疗中心、接受三维适形放疗的老年食管癌患者资料，对患者临床特征行χ²检验，对剂量体积参数等因素行Logistic单因素及多因素分析，确定与发生≥2级放射性肺炎的独立相关因素，并通过ROC曲线分析独立相关因素的最佳分界值。
结果（1）三维适形放疗后共20%的老年食管癌患者发生了≥2级放射性肺炎，单因素分析提示双肺V5、V10、V20、V30及肺平均剂量（MLD）是≥2级放射性肺炎的相关因素；（2）多因素分析提示双肺V5、V20是≥2级放射性肺炎的独立相关因素；（3）ROC曲线提示控制放射性肺炎发生的最佳分界值为V5＜53.9%，V20＜23.2%。
结论双肺V5和V20是老年食管癌患者三维适形放疗后发生≥2级放射性肺炎的独立相关因素。

Abstract:
Objective To analyze the correlation between ≥grade 2 radiation pneumonitis (RP) and dose volume parameters of elderly patients with esophageal cancer after three-dimensional conformal radiotherapy.
Methods We collected the data of 250 elderly patients with esophageal cancer who received three-dimensional conformal radiotherapy from different medical centers. The clinical features of patients were analyzed by Chi-square test while dose volume parameters were analyzed by Logistic univariate and multivariate analyses. ROC curve was used to determine the best cut-off value.
Results After three-dimensional conformal radiotherapy, 20% of patients developed ≥grade 2 RP. Univariate analysis showed that bilateral pulmonary V5, V10, V20, V30 and mean lung dose were associated with ≥grade 2 RP but multivariate analysis revealed that only V5 and V20 were independent relevant factors of RP. ROC curve indicated that the best cut-off value was V5 < 52.9% and V20 < 23.2%.
Conclusion Bilateral pulmonary V5 and V20 are independently related to ≥grade 2 RP in elderly patients with esophageal cancer after 3-D conformal radiotherapy.

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