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目的探讨Ⅲ期非小细胞肺癌三维适形放疗前后肺功能、DVH参数与放射性肺炎发生程度的关系。方法71例未手术的肺癌患者,男52例,女19例,中位年龄63岁,KPS评分≥80。三维适形放疗前、后1、3个月检查患者肺功能,并观察其放射性肺炎的发生及程度,同时在DVH中得出V_(20)、V_(30)、MLD值。结果所有患者均完成放疗,剂量为66～70Gy。放射性肺炎发生率为30%,2、3级以上为7%。V_(20)、V_(30)、MLD平均值越大,放射性肺炎程度越高。V_(20)、V_(30)及MLD与C_LCO疗前和疗后1、3个月变化及疗后1个月和疗后3个月变化均有相关关系。结论放疗前后肺功能变化、DVH参数和放射性肺炎程度间存在一定相关关系。放疗后1个月与放疗前C_LCO数值变化能更好地预测放射性肺炎发生几率；V_(20)、V_(30)、MLD除了与放射性肺炎发生程度相关外,也与放疗前后C_LCO、FEV_1的变化有关。
Objective To investigate the relationship between pulmonary function, DVH parameters and the incidence of radiation pneumonitis before and after three-dimensional conformal radiotherapy in stage Ⅲ non-small cell lung cancer. Methods 71 cases of lung cancer without surgery, 52 males and 19 females, the median age of 63 years, KPS score ≥ 80. Three and a half weeks after conformal radiotherapy, pulmonary function was examined at 1 and 3 months after operation, and the occurrence and extent of radiation pneumonitis were observed. V_ (20), V_ (30) and MLD values were also obtained in DVH. Results All patients completed radiotherapy, the dose was 66 ~ 70Gy. The incidence of radiation pneumonitis was 30%, 2,3 and 7%. V_ (20), V_ (30), MLD average, the higher the degree of radiation pneumonitis. The changes of V_ (20), V_ (30) and MLD were related with C_LCO before and 1, 3 months after treatment and at 1 month after treatment and 3 months after treatment. Conclusion Before and after radiotherapy, pulmonary function changes, DVH parameters and the degree of radiation pneumonitis have a certain correlation. V_ (20), V_ (30), MLD in addition to the degree of occurrence of radiation pneumonia, but also with the changes of C_LCO before and after radiotherapy, FEV_1 changes related.