Analysis Of Related Factors Associated With Radiation-induced Lung Injury Caused By Intensity Modulated Radiotherapy For Thoracic Tumours

Objective:To investigate the related factors of radiation-induced lung injury in patients with thoracic tumor treated by intensity modulated radiotherapy（IMRT）.Methods:Objective to analyze the clinical data of 104 patients who received intensity-modulated radiation therapy（IMRT）for thoracic tumor in the radiotherapy department of Shijiazhuang Pingan Hospital from January2016 to March 2018,including gender,age,anamnesis in lung diseases,underlying health condition,smoking history,radiation dose,application of traditional Chinese medicine,radiotherapy plan parameters derived from DVH,including V₅,V₁₀,V₂₀,V₃₀,average dose of both lungs,PTV volume,volume of both lungs and the occurrence of radiation-induced lung injury.Radiation-induced lung injury was graded according to the RTOG grading standards of radiation pneumonia,and the end point of follow-up was≥2grade radiation-induced lung injury within 3 months after radiotherapy.All data were recorded and analysed in IBM SPSS Statistics,version 26.0.Results:The incidence of grade≥2 radiation-induced lung injury in the whole group was 28.85%（30/104）,of which the incidence of grade 2 was25.96%（27/104）,the incidence of grade 3 was 2.88%（3/104）,and there was no grade 4 radiation-induced lung injury.Univariate analysis showed that there were statistical differences in the occurrence of radiation-induced lung injury in terms of the anamnesis in lung diseases,V₂₀ in both lungs,and whether traditional Chinese medicine was applied（P values were 0.000,0.011,and 0.003,all less than 0.05）.Multivariate regression analysis showed that the anamnesis in lung diseases and V₂₀ in both lungs were independent factors influencing the occurrence of radiation-induced lung injury of grade≥2（P values were 0.000 and 0.007 respectively）.Syndrome differentiation in traditional Chinese medicine can reduce the occurrence of radiation-induced lung injury of grade≥2（P value is 0.039）.Conclusion:In the intensity-modulated radiotherapy for thoracic tumors,the anamnesis in lung diseases,whether traditional Chinese medicine was applied and V₂₀ in both lungs are independent risk factors that affect the occurrence of radiation lung injury of grade≥2.The application of traditional Chinese medicine based on syndrome differentiation can reduce the occurrence of grade≥2 radiation lung injury.