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辐射诱导肺纤维化的特征与剂量学参数相关。

The features of radiation induced lung fibrosis related with dosimetric parameters.

机构信息

Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.

出版信息

Radiother Oncol. 2012 Mar;102(3):343-6. doi: 10.1016/j.radonc.2012.02.003. Epub 2012 Feb 17.

Abstract

BACKGROUND AND PURPOSE

Radiation induced lung fibrosis (RILF) is a major complication after lung irradiation and is very important for long term quality of life and could result in fatal respiratory insufficiency. However, there has been little information on dosimetric parameters for radiotherapy planning in the aspect of RILF. The features of RILF related with dosimetric parameters were evaluated.

METHODS AND MATERIALS

Forty-eight patients with non-small cell lung carcinoma who underwent post-operative radiation therapy (PORT) without adjuvant chemotherapy were analyzed. The degree of lung fibrosis was estimated by fibrosis volume and the dosimetric parameters were calculated from the plan of 3-dimensional conformal radiotherapy.

RESULTS

The fibrosis volume and V-dose as dosimetric parameters showed significant correlation and the correlation coefficient ranged from 0.602 to 0.683 (P<0.01). The degree of the correlation line was steeper as the dose increase and threshold dose was not found. Mean lung dose (MLD) showed strong correlation with fibrosis volume (correlation coefficient = 0.726, P<0.01).

CONCLUSIONS

The fibrosis volume is continuously increased with V-dose as the reference dose increases. MLD is useful as a single parameter for comparing rival plans in the aspect of RILF.

摘要

背景与目的

放射性肺纤维化(RILF)是肺部照射后的主要并发症,对长期生活质量非常重要,可能导致致命的呼吸功能不全。然而,关于放射性肺纤维化放疗计划方面的剂量学参数信息较少。本研究评估了与剂量学参数相关的放射性肺纤维化特征。

方法和材料

对 48 例非小细胞肺癌患者进行了术后放射治疗(PORT)而未接受辅助化疗。通过纤维化体积来评估肺纤维化的程度,并从三维适形放疗计划中计算剂量学参数。

结果

纤维化体积和 V 剂量作为剂量学参数显示出显著相关性,相关系数范围为 0.602 至 0.683(P<0.01)。随着剂量增加,相关性线的斜率变陡,且未发现阈值剂量。平均肺剂量(MLD)与纤维化体积呈强相关性(相关系数=0.726,P<0.01)。

结论

纤维化体积随参考剂量 V 剂量的增加而持续增加。MLD 作为 RILF 方面比较竞争方案的单一参数是有用的。

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