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.
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