肺癌常规放疗所致急性放射性肺炎和放射剂量的关系及其防治

目的：回顾性分析常规放疗剂量和照射面积与急性放射性肺炎发生率的关系及其治疗效果.方法：自1996年12月至2001年12月,183例肺癌患者于海军总医院和解放军第一○七医院进行常规放射治疗,放射剂量为2 Gy/次,1次/d,5次/周,总剂量为50～70 Gy.结果：急性放射性肺炎发生19例,发生率为10.4%;照射55 Gy以下、55～65 Gy、65 Gy以上的急性放射性肺炎发生率分别为6.0%、8.7%、15.6%;平均照射面积120 cm2以下、120 cm^2以上的急性放射性肺炎发生率分别为8.5%、11.9%.本组肺炎经治疗缓解率为84.2%（16/19）.结论：急性放射性肺炎的发生率随常规照射剂量和照射面积的增大而增加.经合理治疗可明显缓解症状及体征,但应以预防为主.

Clinical analysis of 19 patients with acute radiation pneumonitis in the standard radio therapy

Objective: To analyze retrospectively the relationship between radiation dosage and the area affected and the incidence of acute radiation pneumonitis, as well as therapeutic efficacy of acute radiation pneumonitis with standard radiotherapy. Methods: From Dec. 1996 to Dec. 2001, 183 patients with lung cancer were treated with standard radiotherapy in the Navy General Hospital and the No. 107 Hospital. The treatment profile was 2 Gy per exposure, 1 exposure per day; 5 days per week, with an accumulated dosage of 50-70 Gy. Results: There occurred 19 cases of acute radiation pneumonitis, with an incidence of 10.4%. For irradiations with a dosage of below 65 Gy, over 55-65 Gy and over 65 Gy, the incidence of acute radiation pneumonitis was 6%, 8.7 % and 15.6% respectively. The incidence with an irradiation area of below 120 cm2 and above 120 cm2 was 8.54% and 11.88% respectively. For the treatment group, the remission rate of acute radiation pneumonitis was 84.21% (16/19). Conclusion: The incidence of acute radiation pneumonitis rises with an increase in the irradiation dosage and area following standard radiotherapy. With proper treatment, obvious symptoms and signs could be relieved. But the most important thing is to take preventive measures first.