老年人胸部恶性肿瘤放疗致放射性肺炎的多因素分析

摘要

目的 分析老年人胸部恶性肿瘤放疗后发生放射性肺炎的相关危险因素.方法 回顾性分析2010年1月至2014年1月在本院行放射治疗的440例胸部恶性肿瘤患者临床资料,对其中76例放疗后导致放射性肺炎的患者资料与同期其他患者临床资料进行对比,应用非条件Logistic回归,分析放射性肺炎与吸烟、肺功能障碍、联合化疗、放射剂量和放射部位的相关性.结果 老年胸部肿瘤放疗患者发生放射性肺炎的发生率为17.27％.多因素非条件Logistic回归分析示吸烟、肺功能障碍、联合化疗、放射剂量和放射部位均与放射性肺炎具有明显相关性(x2=16.936、19.633、11.531、17.133、10.178,P＜0.05).相关性大小依次为肺功能障碍、放射剂量、吸烟、联合化疗和放射部位.结论 老年人胸部恶性肿瘤放疗后会导致放射性肺炎的因素较多,其中与吸烟、化疗前动脉血氧分压值＜80％、联合化疗、放射剂量≥55 Gy和下肺放射有关.且相关性大小依次为化疗前动脉血氧分压值＜80％、放射剂量≥55 Gy、吸烟、联合化疗和下肺放射.%Objective To investigate elderly patients with thoracic radiotherapy nausea result after risk factors associated with radiation pneumonitis.Methods The clinical data of a total of 440 cases of cancer patients with chest radiation therapy during January 2010-January 2014 were collected retrospectively.Of them,76 cases of radiation pneumonitis after radiotherapy were compared with other patients.The unconditional Logistic regression analysis was used to analyze the relationship of radiation pneumonitis and different factors including smoking,pulmonary dysfunction,combination with chemotherapy,radiation dose,and radiation sites.Results Elderly incidence of radiation pneumonitis was 17.27％.Multivariate Logistic regression analysis revealed the chi-square value of smoking,pulmonary dysfunction,combined with chemotherapy,radiation dose,and radiation sites was significant correlation (x2 =16.936,19.633,11.531,17.133,10.178,P ＜0.05),and the correlation degree was gradually decreased from pulmonary dysfunction,radiation dose,smoking,combined chemotherapy,to radiation site.Conclusions Elderly patients with thoracic malignancies after radiotherapy had more radiation pneumonitis,which was related to smoking,previous chemotherapy PO2 ＜ 80％,combined with chemotherapy,radiation dose ≥ 55 Gy,and low-lung radiation.The correlation degree was gradually decreased from chemotherapy before PO2 ＜ 80％,the radiation dose ≥55 Gy,smoking,combined chemotherapy,to low-lung radiation.