非小细胞肺癌患者放疗前后肺功能变化与放射性肺炎的相关性研究

目的 观察接受三维适形放疗治疗的局部晚期非小细胞肺癌患者肺功能变化与放射性肺炎的关系。方法 收集76例局部晚期非小细胞肺癌患者，记录放疗前1周、放疗后1个月和3个月的肺功能，观察其与发生放射性肺炎的相关性。结果 所有患者均完成放疗，剂量为60～70 Gy。发生不同程度的放射性肺炎患者26例（A组），其中1级22例，2级3例，3级1例，无 4级和5级病例。未发生放射性肺炎患者50例（B组）。放疗前A组第一秒用力呼气容积（FEV1）明显低于 B组（51.67±19.03）%比（69.03±14.54）%]，差异有统计学意义（t＝2.34，P＜0.05）。两组放疗后1个月和3个月用力肺活量（FVC）相比，差异无统计学意义（P＞0.05）。A组放疗后1个月和3个月肺一氧化碳弥散量（DLCO）分别为（79.04±11.01）%、（57.75±12.04）%，差异有统计学意义（t＝2.98，P＜0.01）；B组放疗后1个月和3个月DLCO分别为（81.46±12.18）%、（57.18±12.95）%，差异有统计学意义（t＝1.96，P＜0.05）。结论 局部晚期非小细胞肺癌患者放疗前FEV1较低者易发生放射性肺炎，DLCO 水平明显降低的患者易发生放射性肺炎。FEV1和DLCO是预测放射性肺炎的敏感指标。

A correlation research of pulmonary function before and after radiation therapy and radiation-induced pneumonitis in patients with advanced non-small-cell lung cancer

Objective To discuss the relationship between lung function before and after radiotherapy and radiation-induced pneumonitis in locally advanced non-small-cell lung cancer. Methods 76 patients were evaluated by pulmonary function tests before radiotherapy and in 1 month and 3 month after radiotherapy respectively. Results All patients were treated radiotherapy with irradiation dose of 60-70 Gy, the radiation pneumonitis occurred in 26 patients （group A）, 22 patients were grade 1, 3 patients were grade 2, 1 patient grade 3 and no patient was grade 4 and 5. 50 patients without radiation pneumonitis were group B. There were significant difference between group A and group B for FEV1 before radiotherapy （51.67±19.03） %, （69.03±14.54） %, t = 2.34, P 〈 0.05]. There were no significant difference between in 1 month and 3 months after radiotherapy for FVC （P 〉 0.05）. There was significant difference between in 1 month and 3 months after radiotherapy for DLCO （group A, P 〈 0.01; group B, P 〈 0.05）. Conclusions For locally advanced non-small-cell lung cancer patients, the lower of FEV1 before radiotherapy inclineds to develop radiation pneumonitis, DLCO levels are lower significantly in patients prones to radiation pneumonitis. FEV1 and DLCO are sensitive indicators to predict radiation pneumonitis.