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目的 探讨食管癌三维技术放疗后不同分级放射性肺炎的临床特征及危险因素.方法 回顾性分析229 例食管癌三维技术放疗患者的放射性肺炎发生情况,比较不同分级放射性肺炎患者临床特征、治疗模式、剂量学相关指标的差异.结果 全组共89 例发生放射性肺炎,其中发生1、2、3放射性肺炎的患者分别为52 例、32 例、5 例,未发生4、5级放射性肺炎.不同分级放射性肺炎与患者年龄、性别、T分期、N分期、TNM分期、GTV体积等临床特征比较,差异均无统计学意义(P均＜0.05);同期放化疗和单纯放疗患者放射性肺炎分级比较,差异有统计学意义(P＝0.006);放疗剂量和三维技术对放射性肺炎分级无明显影响(P均＞0.05).不同分级放射性肺炎的肺平均剂量、V5、V10、V15、V20、V30比较,差异均有统计学意义(P均＜0.05).结论 食管癌三维技术放疗后放射性肺炎严重程度分级与患者是否同步化疗和放射剂量学参数有关.“,”Objective To investigate the clinical characteristics and risk factors for various radiation pneumonitis after three-dimensional radiotherapy in esophageal carcinoma patients. Methods A total of 229 esophageal carcinoma cases with radiation pneumonitis after three-dimensional radiotherapy were included in this retrospective analysis. Then a comparative study was carried out to compare the differences between the clinical symptoms, treatment model and dosage in the patients with various radiation pneumonitis. Results 89 cases showed radiation pneumonitis, among which the number of cases with grade 1, 2 and 3 radiation pneumonitis was 52, 32 and 5, respectively. No cases showed grade 4 or 5 radiation pneumonitis. No statistical differences were noticed in the age, sex, T stage, N stage, TNM stage and GTV between the cases with various radiation pneumonitis (P＞0.05). Statistical differences were observed in the grade of radiation pneumonitis in the cases received radiochemotherapy compared with those only received radiotherapy (P＝0.006). The radiation dosage and three dimensional technique showed no effects on the severity of radiation pneumonitis (P＞0.05). Significant differences were observed in the mean lung volume, V5, V10, V15, V20 and V30 in those of various radiation pneumonitis (P＜0.05). Conclusion The severity of radiation pneumonitis in the esophageal cancer patients is correlated with the concomitant chemotherapy and radiation dosage.