放疗前肺功能检测FEV1%、FEV1/FVC、DLCO%指标对预测老年非小细胞肺癌患者放射性肺炎方面的价值探究(1)
【摘要】 目的 探討放疗前肺功能检测第1秒用力呼气容积(FEV1%)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)、一氧化碳弥散量占预计值的百分比(DLCO%)指标对预测老年非小细胞肺癌患者放射性肺炎方面的价值。方法 96例老年非小细胞肺癌患者， 均于放疗前进行肺功能检测， 接受三维适形放疗或三维适形调强放疗， 39例采用单纯放疗， 57例采用放化疗联合治疗。统计患者的放射性肺炎发生情况， 并分析放射性肺炎分级;统计比较发生放射性肺炎及未发生放射性肺炎患者的性别、是否合并化疗、FEV1%、FEV1/FVC、DLCO%、放疗剂量等指标， 进行发生放射性肺炎的单因素分析， 放射性肺炎发生的独立危险因素采用多因素Logistic回归分析。结果 96例患者中， 有58例发生放射性肺炎， 发生率为60.42%， 其中Ⅰ级38例(65.52%)， Ⅱ级18例(31.03%)， Ⅲ级2例(3.45%)。放疗前肺功能指标FEV1%、FEV1/FVC、DLCO%均是导致放射性肺炎的重要诱导因素(P<0.05)。经多因素Logistic回归分析显示， FEV1%、FEV1/FVC、DLCO%肺功能指标不是放射性肺炎发生的独立危险因素(P>0.05)。结论 放疗前肺功能检测FEV1%、FEV1/FVC、DLCO%指标在放射性肺炎的预测中具有一定价值， 其高危因素为肺功能受损， 但并不是影响其发生的独立危险因素。
【关键词】 放疗;肺功能检测;第1秒用力呼气容积占预计值的百分比;第1秒用力呼气容积占用力肺活量的百分比;一氧化碳弥散量占预计值的百分比;非小细胞肺癌;放射性肺炎;预测价值
DOI：10.14163/j.cnki.11-5547/r.2019.20.004
Investigation on value of pulmonary function testing of FEV1%， FEV1/FVC and DLCO% in predicting radiation pneumonia of elderly patients with non-small cell lung cancer before radiotherapy LI Tong-yuan， CHEN Lu-qing， WANG Xiao-hong， et al. Weifang Second People’s Hospital， Weifang 261041， China
【Abstract】 Objective To discuss the value of pulmonary function testing of forced expiratory volume in the first second as percentage of predicted value (FEV1%)， percentage of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC) and carbon monoxide diffusing capacity as percentage of predicted value (DLCO%) in predicting radiation pneumonia of elderly patients with non-small cell lung cancer before radiotherapy. Methods A total of 96 elderly patients with non-small cell lung cancer received pulmonary function testing of three-dimensional conformal radiotherapy or three-dimensional conformal intensity modulated radiotherapy before radiotherapy. 39 patients received simple radiotherapy and 57 patients received combined radiotherapy and chemotherapy. The incidence of radiation pneumonia was counted and the classification of radiation pneumonia was analyzed. The gender， whether combined with chemotherapy， FEV1%， FEV1/FVC， DLCO%， radiation dose and other indicators of patients with radiation pneumonia and those without radiation pneumonia were compared and conducted for univariate analysis of radiation pneumonia. The independent risk factors for radiation pneumonitis was analyzed by multivariate Logistic regression analysis. Results There were 58 radiation pneumonia cases in 96 patients， and the incidence rate was 60.42%， including 38 cases (65.52%) in grade Ⅰ， 18 cases (31.03%) in grade Ⅱ， and 2 cases (3.45%) in grade Ⅲ. Pulmonary function indexes of FEV1%， FEV1/FVC and DLCO% were the important inducing factors of radiation pneumonia before radiotherapy (P<0.05). Multivariate logistic regression analysis showed that FEV1%， FEV1/FVC and DLCO% were not independent risk factors for radiation pneumonia (P>0.05). Multivariate Logistic regression analysis showed that FEV1%， FEV1/FVC and DLCO% were not independent risk factors for radiation pneumonia (P>0.05). Conclusion Pulmonary function testing of FEV1%， FEV1/FVC and DLCO% before radiotherapy have certain value in the prediction of radiation pneumonia. The high risk factor is impaired lung function， but it is not an independent risk factor affecting the occurrence of radiation pneumonia., http://www.100md.com(李同源 陈鲁青 王晓红 相法军 高志强 孙振友 程会云)
【关键词】 放疗;肺功能检测;第1秒用力呼气容积占预计值的百分比;第1秒用力呼气容积占用力肺活量的百分比;一氧化碳弥散量占预计值的百分比;非小细胞肺癌;放射性肺炎;预测价值
DOI：10.14163/j.cnki.11-5547/r.2019.20.004
Investigation on value of pulmonary function testing of FEV1%， FEV1/FVC and DLCO% in predicting radiation pneumonia of elderly patients with non-small cell lung cancer before radiotherapy LI Tong-yuan， CHEN Lu-qing， WANG Xiao-hong， et al. Weifang Second People’s Hospital， Weifang 261041， China
【Abstract】 Objective To discuss the value of pulmonary function testing of forced expiratory volume in the first second as percentage of predicted value (FEV1%)， percentage of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC) and carbon monoxide diffusing capacity as percentage of predicted value (DLCO%) in predicting radiation pneumonia of elderly patients with non-small cell lung cancer before radiotherapy. Methods A total of 96 elderly patients with non-small cell lung cancer received pulmonary function testing of three-dimensional conformal radiotherapy or three-dimensional conformal intensity modulated radiotherapy before radiotherapy. 39 patients received simple radiotherapy and 57 patients received combined radiotherapy and chemotherapy. The incidence of radiation pneumonia was counted and the classification of radiation pneumonia was analyzed. The gender， whether combined with chemotherapy， FEV1%， FEV1/FVC， DLCO%， radiation dose and other indicators of patients with radiation pneumonia and those without radiation pneumonia were compared and conducted for univariate analysis of radiation pneumonia. The independent risk factors for radiation pneumonitis was analyzed by multivariate Logistic regression analysis. Results There were 58 radiation pneumonia cases in 96 patients， and the incidence rate was 60.42%， including 38 cases (65.52%) in grade Ⅰ， 18 cases (31.03%) in grade Ⅱ， and 2 cases (3.45%) in grade Ⅲ. Pulmonary function indexes of FEV1%， FEV1/FVC and DLCO% were the important inducing factors of radiation pneumonia before radiotherapy (P<0.05). Multivariate logistic regression analysis showed that FEV1%， FEV1/FVC and DLCO% were not independent risk factors for radiation pneumonia (P>0.05). Multivariate Logistic regression analysis showed that FEV1%， FEV1/FVC and DLCO% were not independent risk factors for radiation pneumonia (P>0.05). Conclusion Pulmonary function testing of FEV1%， FEV1/FVC and DLCO% before radiotherapy have certain value in the prediction of radiation pneumonia. The high risk factor is impaired lung function， but it is not an independent risk factor affecting the occurrence of radiation pneumonia., http://www.100md.com(李同源 陈鲁青 王晓红 相法军 高志强 孙振友 程会云)