摘要
目的通过CT随访观察,探讨肝癌三维适形放射治疗后早期肝实质放射性损伤的CT改变及其相关因素.方法选取52例原发性肝癌患者,在13～28 d内实施三维适形放射治疗,总量为35～65(49.88±7.23)Gy.患者在放射治疗结束后1～6个月复查CT,观察放射性肝损伤的表现,并应用logistic回归方法,分析早期放射性肝损伤的发生与性别、年龄、是否合并肝硬化、介入治疗、术后复发、靶体积、照射野数量、照射剂量及分割剂量的关系.结果31例患者(占59.6%)CT呈现与照射区分布一致的低密度区.照射剂量、分割剂量、照射靶体积对早期放射性肝损伤的发生有显著影响;性别、年龄、是否合并肝硬化、介入治疗、术后复发对放射治疗后早期CT观察放射性肝损伤发生与否的影响无显著意义.结论治疗靶体积、照射剂量、分割剂量与CT观察放射性肝损伤的发生有明确相关关系,随着靶体积、照射剂量、分割剂量增加,发生几率增加.
Objective To i nvestigate the CT findings and define the risk factors for early hepatic injury induced by three-dimensional conformal radiation therapy in patients with prim ary liver cancer. Methods This study recruited 52 patients with primary liver c ancer undergoing photon beam radiation at a total dose of 35 to 65 Gy (49.88±7. 23 Gy) completed within 18 to 31 d. CT examinations were performed within 1 to 3 months after the completion of the therapy, and logistic regression was used t o analyze the CT features of early hepatic injury, in an attempt to define the c orrelation of the injury occurrence with such factors as the patients' age, gen der, treatment portal numbers, liver cirrhosis, transcatheter arterial embolizat ion (TACE), postoperative recurrence, total radiation dose, target volume and f ractional dose. Results Thirty-one (59.6%) patients showed CT features of hepat ic injury, displayed as the area with hypodensity in consistency with the radiat ion coverage. The risk factors correlated to the injury occurrence included the total dose, target volume and fractional dose, but not the patients'age, gende r, treatment portal number, liver cirrhosis, TACE, postoperative recurrence diff eronces and radiation-iduced hepatic injury. Conclusion Early radiation-induced hepatic injury is related to fractional dose, total dose and target volume adop ted in radiation therapy. Higher fractional dose, total irradiated dose and lar ger target volume may result in increased risk of injury.
出处
《第一军医大学学报》
CSCD
北大核心
2003年第5期479-482,共4页
Journal of First Military Medical University
基金
广东省自然科学基金重点项目(013056)~~
关键词
三维适形放射治疗
肝肿瘤
体层摄影术
X线计算机
放射性肝损伤
three-dimensi onal conformal radiation therapy
liver neoplasms
tomography, X-ray computed
r adiation-induced hepatic injury
