Radiation Induced Acute Lung Injury In Three Dimensional Conformal Radiotherapy For Thorax Tumor

Objective: To investigate the relationship between dose volume, clinical state, transforming growth factor batal (TGF-β 1) and acute post-irradiation lung injury in thorax tumor treated with three dimensional conformal radiotherapy (3-DCRT), in order to predict the acute post-irradiation lung injury and optimize the radiotherapy plan. Methods: 84 such patients' clinical and dose-volume histograms (DVH) data was collected and test their plasma TGF-β1 levels of pre-RT and post-RT with ELISA method. Logistic regression method was used to test their relativities. Results: According to the RTOG criteria, acute post-irradiation lung injury was observed 19 cases (22. 62%), with 8 in grade Ⅰ , with 5 in grade Ⅱ, with 5 in grade Ⅲ, with 1 in grade IV. The foundation lung function, lung V20, chemotherapy, difference of plasma TGF-β 1 level of pre-RT and post-RT were significantly correlated with acute post-irradiation injury (P<0.05); Levels of plasma TGF-β 1 in post-RT is lower than in pre-RT. Multilogistic regression analysis showed that the foundation lung function (OR=3.945), lung V20(OR=3.094), were the independent factors for acute radiation lung injury. Lung V20 was significantly correlated with acute radiation injury (r=0.440, P<0.001). Conclusions: The foundation lung function and lung V20 are significantly associate with the acute post-irradiation lung injury in thorax tumor treated with 3-DCRT. These factors should be given special consideration...