Shi Ling-Ling, Yang Jiang-Hua, Yao Hong-Fa
Department of Radiology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China.
World J Clin Cases. 2023 Feb 16;11(5):1040-1048. doi: 10.12998/wjcc.v11.i5.1040.
Radiation pneumonitis (RP) is a severe complication of thoracic radiotherapy that may lead to dyspnea and lung fibrosis, and negatively affects patients' quality of life.
To carry out multiple regression analysis on the influencing factors of radiation pneumonitis.
Records of 234 patients receiving chest radiotherapy in Huzhou Central Hospital (Huzhou, Zhejiang Province, China) from January 2018 to February 2021, and the patients were divided into either a study group or a control group based on the presence of radiation pneumonitis or not. Among them, 93 patients with radiation pneumonitis were included in the study group and 141 without radiation pneumonitis were included in the control group. General characteristics, and radiation and imaging examination data of the two groups were collected and compared. Due to the statistical significance observed, multiple regression analysis was performed on age, tumor type, chemotherapy history, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), carbon monoxide diffusion volume (DLCO), FEV1/FVC ratio, planned target area (PTV), mean lung dose (MLD), total number of radiation fields, percentage of lung tissue in total lung volume (vdose), probability of normal tissue complications (NTCP), and other factors.
The proportions of patients aged ≥ 60 years and those with the diagnosis of lung cancer and a history of chemotherapy in the study group were higher than those in the control group ( < 0.05); FEV1, DLCO, and FEV1/FVC ratio in the study group were lower than those in the control group ( < 0.05), while PTV, MLD, total field number, vdose, and NTCP were higher than in the control group ( < 0.05). Logistic regression analysis showed that age, lung cancer diagnosis, chemotherapy history, FEV1, FEV1/FVC ratio, PTV, MLD, total number of radiation fields, vdose, and NTCP were risk factors for radiation pneumonitis.
We have identified patient age, type of lung cancer, history of chemotherapy, lung function, and radiotherapy parameters as risk factors for radiation pneumonitis. Comprehensive evaluation and examination should be carried out before radiotherapy to effectively prevent radiation pneumonitis.
放射性肺炎（RP）是胸部放疗的一种严重并发症，可能导致呼吸困难和肺纤维化，并对患者的生活质量产生负面影响。
对放射性肺炎的影响因素进行多元回归分析。
记录2018年1月至2021年2月在湖州市中心医院（中国浙江省湖州市）接受胸部放疗的234例患者的资料，并根据是否发生放射性肺炎将患者分为研究组和对照组。其中，研究组纳入93例放射性肺炎患者，对照组纳入141例未发生放射性肺炎的患者。收集并比较两组患者的一般特征、放疗及影像学检查数据。由于观察到统计学意义，对年龄、肿瘤类型、化疗史、用力肺活量（FVC）、第1秒用力呼气量（FEV1）、一氧化碳弥散量（DLCO）、FEV1/FVC比值、计划靶区（PTV）、平均肺剂量（MLD）、放疗野总数、肺组织在全肺体积中的百分比（vdose）、正常组织并发症概率（NTCP）等因素进行多元回归分析。
研究组中年龄≥60岁、诊断为肺癌且有化疗史的患者比例高于对照组（P<0.05）；研究组的FEV1、DLCO及FEV1/FVC比值低于对照组（P<0.05），而PTV、MLD、野数总数、vdose及NTCP高于对照组（P<0.05）。Logistic回归分析显示，年龄、肺癌诊断、化疗史、FEV1、FEV1/FVC比值、PTV、MLD、放疗野总数、vdose及NTCP是放射性肺炎的危险因素。
我们已确定患者年龄、肺癌类型、化疗史、肺功能和放疗参数是放射性肺炎的危险因素。放疗前应进行综合评估和检查，以有效预防放射性肺炎。
