放射性肺炎：在 III 期非小细胞肺癌患者中采用每日两次放疗同步卡铂和紫杉醇治疗后的结果。

Radiation pneumonitis following twice-daily radiotherapy with concurrent carboplatin and paclitaxel in patients with stage III non-small-cell lung cancer.

机构信息

Department of Radiology, Graduate School of Medicine, Chiba University, Chiba-City, Chiba 260-8670, Japan.

出版信息

Jpn J Clin Oncol. 2010 May;40(5):464-9. doi: 10.1093/jjco/hyp190. Epub 2010 Jan 18.

DOI:10.1093/jjco/hyp190

PMID:20085905

Abstract

OBJECTIVE

To examine the effects of dose-volume factors on the development of radiation pneumonitis in patients with non-small-cell lung cancer who received twice-daily radiotherapy concurrently with carboplatin and paclitaxel chemotherapy.

METHODS

Radiotherapy consisted of twice-daily fractionation of 1.2 Gy, to a total dose of 60 Gy. Weekly carboplatin and paclitaxel were used as a concurrent chemotherapy. Effects of radiotherapy parameters on the development of radiation pneumonitis were retrospectively analyzed.

RESULTS

Fourteen of 37 patients developed Grade 2 or worse (> or = G2) radiation pneumonitis. Grade 2 or worse radiation pneumonitis occurred in all 5 patients with V5 >40%, all 4 patients with V10 >35%, all 4 patients with V13 >32%, 9 of 14 patients with V20 >24% and 8 of 11 patients with V30 >22%, whereas 9 of 32 patients with V5 <40%, 10 of 33 patients with V10 <35%, 10 of 33 patients with V13 <32%, 5 of 23 patients with V20 <24% and 6 of 26 patients with V30 <22%, with respective P values of 0.0045, 0.015, 0.015, 0.015 and 0.008. Eight of 11 patients with a mean lung dose of >14 Gy developed > or = G2 radiation pneumonitis in contrast to 6 of 26 patients with a mean lung dose of <14 Gy (P = 0.008).

CONCLUSIONS

Several cut-off values in the V(dose) and the mean lung dose differentiating probabilities of developing > or = G2 radiation pneumonitis were identified in this combination therapy.

摘要

目的

研究非小细胞肺癌患者接受卡铂和紫杉醇化疗同步每日 2 次放疗时，剂量-体积因素对放射性肺炎发生的影响。

方法

放疗采用 1.2Gy 每日 2 次分割，总剂量 60Gy。每周给予卡铂和紫杉醇同步化疗。回顾性分析放疗参数对放射性肺炎发生的影响。

结果

37 例患者中有 14 例发生 2 级或更高级（>或=G2）放射性肺炎。5 例 V5 >40%、4 例 V10 >35%、4 例 V13 >32%、9 例 V20 >24%和 8 例 V30 >22%的患者均发生 2 级或更高级放射性肺炎，而 V5 <40%、V10 <35%、V13 <32%、V20 <24%和 V30 <22%的患者分别有 9、10、10、5 和 6 例发生 2 级或更高级放射性肺炎（P 值分别为 0.0045、0.015、0.015、0.015 和 0.008）。11 例平均肺剂量>14Gy 的患者中有 8 例发生>或=G2 放射性肺炎，而 26 例平均肺剂量<14Gy 的患者中仅有 6 例发生（P = 0.008）。