■目的是广泛评估乳腺癌患者放射性肺病的影像学特征,并确定影像学改变与剂量学参数和患者相关特征的关系。
■通过病例记录对总共76名正在接受放疗(RT)的乳腺癌患者进行了回顾性研究,治疗计划,剂量测定参数,和胸部计算机断层扫描(CT)扫描。时间间隔,获得了胸部CT扫描,分为1-6个月,7-12个月,RT后13-18个月和18个月以上。评估胸部CT(每位患者一个或多个)是否存在毛玻璃不透明性,间隔增厚,实变/斑片状肺混浊/肺泡浸润,胸膜下空气囊肿,空气支气管图,实质带,牵引支气管扩张,胸膜/胸膜下增厚和肺容量丢失。通过应用Nishioka等人设计的系统对这些改变进行评分。分析Nishioka评分与临床和剂量学因素的关系。
■IBMSPSSStatisticsforWindows,版本22.0(IBMCorp.,Armonk,N.Y.,美国)用于分析数据。
■中位随访时间为49个月。高龄和芳香化酶抑制剂摄入量与1-6个月期间较高的Nishioka评分相关。然而,在多变量分析中发现两者均无统计学意义.放疗后12个月以上CT扫描的Nishioka评分与平均肺剂量呈正相关,V5、V20、V30和V40。接收器工作特征分析显示,同侧肺的V5是预测慢性肺损伤的最可靠的剂量学参数。V5>41%表明放射性肺变化的发展。
■同侧肺保持V5≤41%可以避免慢性肺后遗症。
UNASSIGNED: The aim is to extensively evaluate imaging features of radiation induced lung disease in breast cancer patients and to determine the relationship of imaging alterations with dosimetric parameters and patient related characteristics.
UNASSIGNED: A total of 76 breast cancer patients undergoing radiotherapy (RT) were studied retrospectively by case notes, treatment plans, dosimetric parameters, and chest computed tomography (CT) scans. Time intervals, that chest CT scans were acquired, were grouped as 1-6 months, 7-12 months, 13-18 months and more than 18 months after RT. Chest CTs (one or more for each patient) were assessed for the presence of ground glass opacity, septal thickening, consolidation/patchy pulmonary opacity/alveolar infiltrates, subpleural air cyst, air bronchogram, parenchymal bands, traction bronchiectasis, pleural/subpleural thickening and pulmonary volume loss. These alterations were scored by applying a system devised by Nishioka et al. Nishioka scores were analyzed for the relationship with clinical and dosimetric factors.
UNASSIGNED: IBM SPSS Statistics for Windows, version 22.0 (IBM Corp., Armonk, N.Y., USA) was used to analyze data.
UNASSIGNED: Median follow-up time was 49 months. Advanced age and aromatase inhibitor intake were correlated with higher Nishioka scores for 1-6 months\' period. However, both were found nonsignificant in multivariate analysis. Nishioka scores of CT scans acquired more than 12 months after RT were positively correlated with mean lung dose,
V5, V20, V30, and V40. Receiver operating characteristic analysis revealed that
V5 for ipsilateral lung was the most robust dosimetric parameter predicting chronic lung injury.
V5 >41% indicates the development of radiological lung changes.
UNASSIGNED: Keeping
V5 ≤41% for ipsilateral lung could provide avoiding chronic lung sequelae.