Comparative Study Of Lung Radiation Injury After Implantation And Radiotherapy For Locally Advanced Non-small Cell Lung Cancer After Intensity-modulated Radiotherapy

Objective: In this study,the lung radiation damage of LANSCLC patients after three-dimensional post-implantation radiotherapy and three-dimensional conformal intensity-modulated radiotherapy was compared by pulmonary function test and SPECT lung perfusion imaging.Methods:A total of 50 LANSCLC patients(including 25 patients with post-implantation radiotherapy and 25 patients with intensity-modulated radiotherapy)who received radiotherapy in the Department of Oncology,Affiliated Hospital of Southwest Medical University from July 2011 to August2020 were collected.The clinical stages of the above patients were all Ⅲ-ⅣA non-small cell lung cancer,and the follow-up time was more than 6 months.Lung perfusion imaging examination and pulmonary function examination were conducted in patients for follow-up,and the degree of lung tissue damage caused by three-dimensional post-implantation radiotherapy and intensity-modulated radiotherapy was compared through the results of these two examinations.Results:1.The comparison of pulmonary function test results after three-dimensional post-implantation radiotherapy and intensity-modulated radiotherapy showed that the FEV1 of the latter was lower than that of the former,respectively(2.65 vs 1.94,P<0.05),with a statistical difference.2.There was 1 case of ≥ grade 2 radiation pulmonary fibrosis in three-dimensional post-implantation radiotherapy,and the incidence rate was4%.There were 6 cases of ≥ grade 2 radiation pulmonary fibrosis in patients with intensity-modulated radiotherapy,and the incidence rate was 24%.The difference between the two groups was statistically significant(P<0.05).3.The comparison of lung perfusion examination after three-dimensional post-implantation radiotherapy and intensity-modulated radiotherapy showed that the volume of lung perfusion damage was smaller in the former(126cm3vs 150cm3,P<0.05),and the difference was statistically significant.Conclusion:1.Lung perfusion imaging is an effective and simple method to observe the changes of blood perfusion and ventilation function of lung tissue after radiotherapy in patients with lung cancer;Intensive radiotherapy is less;3.Three-dimensional post-implantation radiotherapy has significantly lower lung function damage than IMRT,especially FEV1 and FEV1/FVC%.4.The volume of pulmonary perfusion defect in patients receiving three-dimensional post-implantation radiotherapy was significantly lower than that in IMRT.