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血浆内皮素-1与放射性肺损伤的关系[J]. 肿瘤防治研究, 2009, 36(06): 493-496. DOI: 10.3971/j.issn.1000-8578.2009.06.012
引用本文: 血浆内皮素-1与放射性肺损伤的关系[J]. 肿瘤防治研究, 2009, 36(06): 493-496. DOI: 10.3971/j.issn.1000-8578.2009.06.012
Relationship between Plasema Endothelin-1 Level and Radiation-induced Lung Injury[J]. Cancer Research on Prevention and Treatment, 2009, 36(06): 493-496. DOI: 10.3971/j.issn.1000-8578.2009.06.012
Citation: Relationship between Plasema Endothelin-1 Level and Radiation-induced Lung Injury[J]. Cancer Research on Prevention and Treatment, 2009, 36(06): 493-496. DOI: 10.3971/j.issn.1000-8578.2009.06.012

血浆内皮素-1与放射性肺损伤的关系

Relationship between Plasema Endothelin-1 Level and Radiation-induced Lung Injury

  • 摘要: 目的 探讨肺癌放疗前、中、后血浆内皮素-1(ET-1)的水平和肺剂量体积因素V20与发生放射性肺损伤的相关性。 方法 接受三维适形放疗的48例原发性非小细胞肺癌患者,肿瘤总照射剂量62~66Gy,常规分割2Gy/次,5次/周。计划控制V20≤30%,脊髓剂量≤45Gy。ELISA方法对每位患者放疗前、放疗40Gy及放疗后血浆ET-1的浓度进行定量检测。 结果 全组放射性肺损伤的发生率为27.1%(13/48)。放疗40Gy时,ET-1升高的患者放射性肺损伤的发生率为41.7%,高于ET-1水平正常者12.5%(P=0.023);放疗结束时ET-1水平升高者放射性肺损伤发生率为44%,显著高于ET-1水平正常者的8.7%(P=0.006); V20≥25%,放疗结束时ET-1升高,放射性肺损伤的发生率为69.2%,明显高于其他组别;而V20<25%,放疗结束时ET-1正常的患者放射性肺损伤的发生率为5.9%,明显低于其他组别。 结论 放疗中及放疗结束后血浆内皮素-1水平升高与放射性肺损伤密切相关。V20≥25%同时放疗结束时血浆ET-1升高者,属于发生放射性肺损伤的高危人群,可作为放射性肺损伤的预测指标,值得临床进一步研究。

     

    Abstract: Objective To investgate the relationship among the plasma ET-1 levels at pre-、 treatment 40Gy and posttreatment stages. Lung Dose-Volume Histogram Parameters V20 and radiation-induced lung injury. Methods Forty-eight non-small cell lung cancer patients receiving 3DCRT were included in this study.The radiation was delivered in 2Gy per fraction,5 fractions per week with the total dose ranging plasma ET-1 at 62~66Gy.The percentage of both lung volume receiving 20Gy or more(V20)was retricted to 30% or less, and the dose of spinal cord was retricted to 45Gy.We use the methods of ELISA to quantitate the concentration of among pre-, 40Gy and posttreatment stages. Results The totle radiation-induced injury was noted among 27.1%(13/48) of patients.The incidence of the radiation induced lung injury was 41.7% among patients with ET-1 levels elevated when received 40Gy,and this was significantly higher than those with normal ET-1 levels (12.5% ) (P=0.023).The incidence of the radiation-induced lung injury was 44% among patients with elevated posttreatment. ET-1 levels were significantly higher than those with normal ET-1 levels (8.7%)(P=0.006). The radiation-induced lung injury developed in 69.2% of patients with V20≥25% and elevated post-treatment ET-1 levels,and this was significantly higher than those of other groups.Those patients with V20<25% and normal post-treatment ET-1 levels have 5.9% developped radiation-induced lung injury,which was significantly lower than those of other groups. Conclusion Radiation-induced lung injury is significantly related to the concentration of plasma ET-1 during and afterradiotherapy. Patients with V20≥25% and elevated posttreatment ET-1 levels are at especially high risk to develop radiation-induced lung injury.It may be regarded as a factor to predict radiation-induced lung injury and is worthy of clinical generalization and further clinical observation.

     

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