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目的:探讨高海拔地区肺癌患者放疗前、后肺功能的变化趋势及规律。方法:总结60例需行放射治疗的肺癌患者的治疗情况,分析年龄、性别、病检、临床分期、化疗、肺部疾病对发生放射性肺炎(radiation pneumonitis,RP)的影响,根据放疗前肺功能检测结果分为正常组和异常组共60例,每组30例,检测放疗前、放疗后肺功能数值的变化,并结合影像学资料,观察其肺功能变化的趋势。结果:患者年龄、临床分期、病理类型、是否合并化疗与RP的发生无明显关系。肺功能一氧化碳弥散量(DLCO)减低在放疗后各时间点上与放疗前相比均具有显著性差异,是放射治疗对患者肺功能损害最敏感指标,Fvc、Fev1.0放疗后肺功能的改变是一个综合因素影响的结果,随着放射治疗后肺部肿瘤的回缩,肺功能有短暂性改善的征象。结论:高海拔地区肺癌患者的放射治疗增加了患者放射性肺炎的风险。在放疗前需评估患者的肺功能,对合并有慢性阻塞性肺疾病(COPD)患者和基础肺功能异常(弥散功能为主)的患者应优选治疗方案,减少和避免正常肺组织的放射性损伤,以提高肿瘤局控率,延长病人生存期。
Objective: To investigate the change trend and regularity of lung function in patients with lung cancer before and after radiotherapy in high altitude area. Methods: The clinical data of 60 lung cancer patients undergoing radiotherapy were summarized. The effects of age, sex, disease examination, clinical stage, chemotherapy and lung disease on radiation pneumonitis (RP) were analyzed. According to the pulmonary function before radiotherapy The test results were divided into normal group and abnormal group, a total of 60 cases, 30 cases in each group, before and after radiotherapy to detect changes in lung function values, combined with imaging data to observe the trends in lung function changes. Results: There was no significant relationship between the age of patients, clinical stage, pathological type, and whether chemotherapy combined with the occurrence of RP. The decrease of DLCO was significantly different from that before radiotherapy at various time points after radiotherapy, which was the most sensitive index of lung function damage in radiotherapy. The change of lung function after Fvc and Fev1.0 radiotherapy Is the result of a combination of factors that, with the retraction of lung tumors after radiotherapy, have transient signs of improvement in lung function. Conclusion: Radiation therapy for patients with lung cancer at high altitudes increases the risk of radiation pneumonitis in patients. The patient’s lung function needs to be assessed prior to radiotherapy. Patients with COPD and underlying pulmonary dysfunction (predominantly with diffuse function) should be treated with a regimen that reduces and avoids radioactive damage in normal lung tissue, To improve the rate of tumor control, to extend the survival of patients.