Analysis Of Influencing Factors Of Radiation-Induced Lung Injury In Patients With Esophageal Cancer Treated By IMRT

Objective: To explore the influencing factors of radiation-induced lung injury(RILI)in esophageal cancer treated with IMRT.Methods: There were 233 patients with esophageal cancer treated with IMRT from January 2014 to December 2016 in Tumor Hospital affiliated to Xinjiang Medical University.All of the patients were divided to 2 groups according to whether acute radiation lung injury occurred:.:with RILI and without RILI.Analysis the influencing factors of radiation-induced lung injury.Including clinical data: age,sex,T staging,lymph node metastasis,pathological type,tumor location,tumor length,chemotherapy mode,KPS score,basic lung disease,diabetes,smoking history,and physical parameters of radiotherapy:double lung V5,V10,V15,V20,V30,mean lung dose(MLD),gross tumor volume(GTV),two lung volume,GTV volume and two lung volume ratio,field number of irradiated,prescription dose.The risk factors of radiation-induced lung injury were screened by Logistic regression analysis.Results: In all groups,there were 63 patients with radiation-induced lung injury,and 25 patients with grade ≥2 RILI.Univariate analysis showed that the positive lymph nodes,GTV volume,GTV volume and two lung volume ratio,MLD,and double lung V5,V10,V15,V20,V30 were significantly different between the two groups.Multivariate analysis showed that V5 ≥63.15%、V30 ≥5.35% were risk factors for RILI.Conclusion:In order to reduce the risk of RILI,we should take full account of the clinical characteristics and the physical indexes such as V5,V30,when evaluating the treatment plan of intensity modulated radiotherapy for esophageal cancer.