摘要目的 研究分析三维适形放疗治疗晚期非小细胞肺癌的临床效果及造成肺损伤情况的相关因素分析.方法 选取大同市第二人民医院2012年5月至2015年5月收治的118例晚期非小细胞肺癌患者,所有患者均经病理确诊,搜集纳入对象的临床资料及治疗方案,分析三维适形放疗与肺损伤之间的相关性.将患者随机分为对照组与观察组,每组59例.对照组采用单纯放疗,观察组采用三维适形放疗,比较两组临床疗效及放疗不良反应发生率.结果 观察组有效率(88.14％)高于对照组(69.49％),P<0.05;观察组放疗不良反应发生率(13.56％)低于对照组(32.20％),P<0.05.多因素分析结果表明,平均肺剂量、肺容积百分比(V20)及肿瘤体积是影响患者发生肺损伤的相关诱导因素;通过Logistic线性回归分析证实,患侧肺的平均肺剂量是导致肺损伤发生的独立危险因素(P<0.05).结论 三维适形放疗治疗晚期非小细胞肺癌的临床疗效显著,但仍然存在少数不良反应,其所致肺损伤与平均肺剂量、V20及肿瘤体积密切相关.

abstractsObjective To study and analyze the related factors of lung injury caused by three-dimensional conformal radiotherapy and clinical outcomes of treatment for patients with advanced non-small-cell lung cancer ( NSCLC ) .Methods A total of 118 patients with advanced NSCLC who were treated in the Second People's Hospital of Datong from May 2012 to May 2015 were selected .All patients were diagnosed by pathology , of which the clinical data and treatment protocols were collected . The correlation between three-dimensional conformal radiotherapy and lung injury was analyzed .Patients were randomly divided into control groups and observation group , with 59 cases in each group .Patients in control group underwent radiotherapy alone and patients in observation group were treated by three-dimensional conformal radiotherapy .The clinical efficacy and incidence of adverse reactions were compared between the two groups .Results The effective rate of observation group ( 88.14％) was significantly higher than that of control group ( 69.49％) , P<0.05;the incidence of adverse reactions in observation group ( 13.56％) was significantly lower than that in control group ( 32.20％) , P<0.05 .The factor analysis results showed that the average lung dose , percentage of lung volume ( V20 ) and tumor volume were related influencing factors of lung injury .Logistic linear regression analysis confirmed that the average lung dose was an independent risk factor of the occurrence of lung injury ( P<0.05 ) .Conclusions The clinical effect of three-dimensional conformal on patients with advanced NSCLC is significant , but there are few adverse reactions .And lung injury caused by advanced NSCLC is closely related to the average lung dose , V20 and tumor volume .