肺癌放疗前中医证候及其他因素与放射性肺损伤相关性研究

摘要

目的 探讨放疗前肺癌中医证候及其他因素与≥2级放射性肺损伤(RILI)的相关性.方法 纳入2013年1月至2015年1月河北省唐山市人民医院放化疗一科接受放疗的肺癌患者154例,收集放疗前中医证候情况,放疗剂量学资料及其他临床情况.根据美国国立癌症研究所不良反应常见术语标准3.0版标准评价RILI级别,以放疗结束后发生的2级RILI作为终点事件,用Logistic回归模型分析影响≥2级RILI发生的相关因素.结果 154例中2级RILI的发生率为27.3％ (42/154).单因素分析显示中医证候,全肺V5、V20、双肺平均剂量(MLD)与≥2级RILI的发生相关.多因素分析显示MLD≥17.7 Gy和中医证候(气阴两虚证和阴虚热毒)是≥2级RILI的独立危险因素(比值比7.139、2.958,均P＜0.05).结论 中医证候中气阴两虚证、阴虚热毒和MLD与≥2级RILI发生密切相关,为≥2级RILI的独立危险因素.%Objective To investigate the correlations between traditional Chinese medicine (TCM) syndromes before radiotherapy as well as other clinical characteristics and ≥2 grade radiation-induced lung injury (RILI) in lung cancer patients.Methods Totally 154 patients with lung cancer receiving radiotherapy from January 2013 to January 2015 were enrolled.The informations of TCM syndromes and other clinical characteristics before radiotherapy were collected.The National Cancer Institute Common Toxicity Criteria version 3.0 was employed to evaluate the classification of RILI,and ≥ 2 grade RILI was defined as endpoint.Logistic regression analysis was used to analyze the risk factors of RILI.Results The incidence of ≥ 2 grade RILI was 27.3％ (42/154).Univariate analysis showed that TCM syndromes,total lung V5,V20,and mean lung dose (MLD) were significantly correlated with ≥ 2 grade RILI.Multivariate analysis showed that MLD and TCM syndromes (Yinxu Redu and Qiyin Liangxu syndromes) were independent risk factors of ≥2 grade RILT(odds ratio:7.139,2.958,P ＜0.05).Conclusion TCM syndromes (Yinxu Redu and Qiyin Liangxu syndromes) and MLD are independent risk factors of ≥2 grade RILI.