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目的:分析非小细胞肺癌术后放疗肺受量与放射性肺炎(RP)的关系,探讨正常肺组织剂量-体积参数对中-重度放射性肺炎(≥2级RP)的预测作用。方法:回顾性分析2014年7月~2016年7月在我院行术后放疗的非小细胞癌患者共150例,记录剂量-体积参数V5、V20、V30、平均肺剂量(MLD)及≥2级RP发生率。多因素分析各个剂量学参数与≥2级RP之间的关系,并对独立影响因素采用ROC曲线分析寻找合适的预测界值。结果:150例患者中,2级RP发生率为12%(18/150),3级RP发生率为6%(9/150),4级RP发生率为1.33%(2/150),≥2级RP总发生率为19.33%(29/150)。多因素分析显示:V5是≥2级RP发生的独立影响因素。经ROC曲线分析,V5预测≥2级RP的合适界值为47.5%。结论:在行术后放疗的肺癌患者中,低剂量-体积参数V5对≥2级RP的发生具有独立的影响作用,需引起重视。
OBJECTIVE: To analyze the relationship between lung volume and radiation pneumonitis (RP) after radiotherapy in non-small cell lung cancer (NSCLC) patients and to investigate the predictive value of dose / volume parameters of normal lung tissue for moderate-severe radiation pneumonitis (≥2 RP). Methods: A total of 150 non-small cell lung cancer patients undergoing postoperative radiotherapy in our hospital from July 2014 to July 2016 were retrospectively analyzed. The dose-volume parameters V5, V20, V30, mean lung dose (MLD) and ≥ Level 2 RP incidence. Multivariate analysis of each dose-related parameters and ≥ 2 RP, and the independent influencing factors using ROC curve analysis to find the appropriate predictive threshold. Results: The incidence of grade 2 RP was 12% (18/150) in 150 patients. The incidence of grade 3 RP was 6% (9/150). The incidence of grade 4 RP was 1.33% (2/150), ≥ The overall incidence of grade 2 RP was 19.33% (29/150). Multivariate analysis showed that V5 was an independent influencing factor for ≥2 level RP. According to the ROC curve analysis, the suitable threshold of V5 predicting ≥2 RP was 47.5%. CONCLUSIONS: Low-dose-volume parameter V5 has an independent effect on the occurrence of ≥2 grade RP in patients with lung cancer undergoing postoperative radiotherapy and needs attention.