肺癌和乳腺癌调强放疗致动态心电图改变的相关因素分析

摘要

Objective To study of the influential factors of dynamic electrocardiogram (DCG)changes after intensity modulated radiation therapy(IMRT) for the lung cancer and breast cancer .Methods IMRT was delivered to 43 patients with lung cancer and 39 patients with breast cancer ,and they were installed DCG before and after the therapy .The associations of clinical and DVH fac‐tors with DCG changed after IMRT were analyzed .Results 32 patients have abnormal DCG after IMRT (39% ) ,the clinical data and physical factors were analyzed by Logistic regression ,gender(OR=1 .52 ,P<0 .05) and heart V40 >22% (OR=1 .15 ,P<0 .05) were the independent influencing factors for abnormal DCG .Conclusion The rate of abnormal DCG is low after IMRT for the lung cancer and breast cancer ,and gender and heart V40 were the independent influencing factors for abnormal DCG .%目的：探讨肺癌和乳腺癌调强放疗（IM RT ）后动态心电图（DCG ）改变的相关因素。方法收集接受IM RT 左肺癌43例和左乳腺癌39例，分别于治疗前后进行24 h DCG监测，分析患者临床资料及剂量‐体积直方图（DV H ）参数对 IM RT 后DCG改变的影响。结果 IM RT后出现DCG改变32例（占39％），将患者临床资料及DV H参数进行 Logistic分析，发现性别（OR＝1．52，P＜0．05）、心脏V40＞22％（OR＝1．15，P＜0．05）与DCG改变密切相关。结论肺癌和乳腺癌患者IMRT治疗后以偶发房（室）性心律失常、S T‐T改变为主，性别及心脏V40是其发生的独立危险因素。