食管鳞癌调强放疗后急性放射性肺炎发生的临床和剂量学相关因素分析
网络出版日期: 2019-02-25
基金资助
国家自然科学基金(81673102);国家自然科学基金(81602791);国家自然科学基金(81803164);国家重点研发计划(2016YFC0105409);上海市卫生和计划生育委员会科研课题青年项目基金(20164Y0066);上海申康医院发展中心临床创新三年行动计划(16CR1037B);上海市教委高峰高原学科临床医学项目(20171904);上海交通大学“医学转化交叉基金”(ZH2018QNA54);综合医院中西医结合专项建设(ZHYY-ZXYJHZX-2-201704)
Clinical and dosimetric factors associated with acute radiation-induced pneumonitis in esophageal carcinoma patients after intensity modulated radiation therapy (IMRT)
Online published: 2019-02-25
郑磊, 赵胜光, 许赪, 蒋徐铭, 曹璐, 吴华玲, 陈佳艺 . 食管鳞癌调强放疗后急性放射性肺炎发生的临床和剂量学相关因素分析[J]. 诊断学理论与实践, 2019 , 18(1) : 66 -71 . DOI: 10.16150/j.1671-2870.2019.01.013
Objective: To analyze the clinical and dosimetric factors associated with radiation-induced pneumonitis (RIP) in esophageal carcinoma patients treated with intensity modulated radiation therapy (IMRT) for developing a predictive model of RIP risk. Methods: Eighty-eight patients with histologically con?rmed esophageal carcinoma treated with IMRT from January 2013 to December 2016 were reviewed retrospectively. Clinical factors and dosimetric parameters were collected, and their correlations with risk of RIP were analyzed. Results: In total, twenty-five cases (28.4%) with grade 1 RIP, 13 (14.8%) with grade 2 RIP, and1 (1.1%) with grade 3 RIP (CTC 4.0) were observed. No grade 4 RIP was found.In univariate analysis, therapy modal of radiation, esophagectomy and dosimetric parameters V5, V10, V20 and mean lung dose (MLD) were significant factors for the development of RIP≥G1 (P<0.05). The V5, V10, V20, MLD were proved to be significant factors for the development of RIP≥G2 (P<0.05). By multivariate analysis, V5 was the only independent predictive factors for the development of RIP≥G1 (P<0.05); V10 was the only independent predictive factor for the development of RIP≥G2 (P<0.05). Conclusions: In comparison with MLD and V20, the widely used dosimetric parameters, our study showes that dosimetric parameters V5 and V10 could be the better predictor of RIP under the background of IMRT for esophageal carcinoma.
| [1] | Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019[J]. CA Cancer J Clin, 2019, 69(1):7-34. |
| [2] | Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132. |
| [3] | Shirvani SM, Juloori A, Allen PK, et al. Comparison of 2 common radiation therapy techniques for definitive treatment of small cell lung cancer[J]. Int J Radiat Oncol Biol Phys, 2013, 87(1):139-147. |
| [4] | Lin SH, Wang L, Myles B, et al. Propensity score-based comparison of long-term outcomes with 3-dimensional conformal radiotherapy vs intensity-modulated radiotherapy for esophageal cancer[J]. Int J Radiat Oncol Biol Phys, 2012, 84(5):1078-1085. |
| [5] | Vogelius IR, Bentzen SM. A literature-based meta-analysis of clinical risk factors for development of radiation induced pneumonitis[J]. Acta Oncol, 2012, 51(8):975-983. |
| [6] | He J, Zeng ZC, Shi SM, et al. Clinical features, outcomes and treatment-related pneumonitis in elderly patients with esophageal carcinoma[J]. World J Gastroenterol, 2014, 20(36):13185-13190. |
| [7] | Kishida Y, Tsushima T, Endo M, et al. Risk Analysis of Pneumonitis in Taxane Therapy After Chemoradiotherapy for Patients With Metastatic or Recurrent Esophageal Cancer[J]. Am J Clin Oncol, 2018, 41(1):41-45. |
| [8] | Shaikh T, Churilla TM, Monpara P, et al. Risk of radiation pneumonitis in patients receiving taxane-based trimodality therapy for locally advanced esophageal cancer[J]. Pract Radiat Oncol, 2016, 6(6):388-394. |
| [9] | Zhao JK, Wu M, Kim CH, et al. Jiangsu Four Cancers Study: a large case-control study of lung, liver, stomach, and esophageal cancers in Jiangsu Province, China[J]. Eur J Cancer Prev, 2017, 26(4):357-364. |
| [10] | Kazerooni EA, Martinez FJ, Flint A, et al. Thin-section CT obtained at 10-mm increments versus limited three-level thin-section CT for idiopathic pulmonary fibrosis: correlation with pathologic scoring[J]. AJR Am J Roentgenol, 1997, 169(4):977-983. |
| [11] | Satoh K, Kobayashi T, Misao T, et al. CT assessment of subtypes of pulmonary emphysema in smokers[J]. Chest, 2001, 120(3):725-729. |
| [12] | Asakura H, Hashimoto T, Zenda S, et al. Analysis of dose-volume histogram parameters for radiation pneumonitis after definitive concurrent chemoradiotherapy for esophageal cancer[J]. Radiother Oncol, 2010, 95(2):240-244. |
| [13] | Nomura M, Kodaira T, Furutani K, et al. Predictive factors for radiation pneumonitis in oesophageal cancer patients treated with chemoradiotherapy without prophylactic nodal irradiation[J]. Br J Radiol, 2012, 85(1014):813-818. |
| [14] | Zhao Y, Chen L, Zhang S, et al. Predictive factors for acute radiation pneumonitis in postoperative intensity modulated radiation therapy and volumetric modulated arc therapy of esophageal cancer[J]. Thorac Cancer, 2015, 6(1):49-57. |
| [15] | Cunliffe A, Armato SG 3rd, Castillo R, et al. Lung texture in serial thoracic computed tomography scans: correlation of radiomics-based features with radiation therapy dose and radiation pneumonitis development[J]. Int J Radiat Oncol Biol Phys, 2015, 91(5):1048-1056. |
| [16] | Chen J, Hong J, Zou X, et al. Association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury after intensity-modulated radiotherapy in lung cancer: a retrospective analysis[J]. J Radiat Res, 2015, 56(6):883-888. |
| [17] | 张丽, 汪志, 崔珍珍, 等. 简化适形调强技术与调强适形放疗在胸段食管癌放疗中的剂量学比较[J]. 安徽医学, 2018, 39(9):1048-1051. |
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