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目的:研究局部晚期非小细胞肺癌(NSCLC)患者强调放射治疗(IMRT)合并化疗时急性食管炎的发生率及相关预测因素。方法:收集IMRT同步化疗未手术Ⅲ期NSCLC患者156例。放疗靶区包括原发肺肿瘤及受累淋巴引流区,中位剂量为60Gy,分30次(50~70Gy)。放疗期间及放疗结束后3个月内出现≥2级急性食管炎作为终点事件,采用CTCAE3.0评估急性食管炎级别,并采用Logistic回归模型对预测因素进行分析。结果:156例中,出现治疗相关≥2级急性食管炎122例(78.2%),其中2级99例(63.5%)、3级23例(14.7%);≥2级急性食管炎发生时的中位剂量为26Gy(8~64Gy);食管V5-V60、食管平均剂量及年龄是≥2级急性食管炎的预测因素(P=0.019、0.0.0.02),其中高龄和高体重指数是保护性因素。结论:局部晚期NSCLC患者IMRT同步化疗时,食管V50对预测≥2级急性食管炎有较高价值。
Objective: To investigate the incidence and related predictors of acute esophagitis in patients with locally advanced non-small cell lung cancer (NSCLC) undergoing radiotherapy (IMRT) combined with chemotherapy. Methods: A total of 156 patients with stage Ⅲ NSCLC undergoing synchronous IMRT were enrolled. Radiotherapy target areas include primary lung tumors and involved lymphatic drainage area, the median dose of 60Gy, 30 times (50 ~ 70Gy). Grade 2 acute esophagitis occurred within 3 months after radiotherapy and within 3 months after radiotherapy. The level of acute esophagitis was assessed by CTCAE3.0, and the predictors were analyzed by Logistic regression model. Results: Among 156 cases, 122 cases (78.2%) of grade 2 acute esophagitis were treated, of which 99 cases (63.5%) in grade 2 and 23 cases (14.7%) in grade 3; The median dose was 26Gy (8 ~ 64Gy). The esophageal V5-V60, mean esophageal dose and age were the predictors of grade 2 or higher esophagitis (P = 0.019,0.0.0.02). The elderly and high body mass index factor. Conclusions: Esophageal V50 has a high value for predicting grade 2 or grade 2 acute esophagitis when IMRT is performed in patients with locally advanced NSCLC.