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Risk Factors of Radiation Pneumonia in 118 Patients with Local Advanced Lung Cancer

SONG Hui-sheng;WANG Xin;TANG Rui-ming;PAN Hui-lin;FENG Zheng-fu;The Sixth Affiliated Hospital of Guangzhou Medical University;  
[Objective] To investigate the factors related to the radiation pneumonia in lung cancer patients. [Methods] The clinical data of 118 patients with locally advanced non-small cell lung cancer(NSCLC) undergoing radical radiotherapy were reviewed. The radiation pneumonia was confirmed by clinical symptoms,chest X-ray and thin-layer CT examination. The factors related to the occurence of radiation pneumonia were examined with univariate and multivariate regression analyses. [Results] Thirty-seven cases of acute radiation pneumonia after radiotherapy were confirmed in 118 patients(31.4%). Univariate analysis showed that radiation pneumonia was significantly associated with concurrent radiochemotherapy,COPD and smoking history(P0.05); patients with GTV135cm,V_(10)47%,V_(25)22%,V_(30)18%,V_(35)15% or V_(40)13% had an increased incidence of radiation pneumonia(all P0.05). Multivariate analysis showed that complication with COPD,V_(10)47%,V_(30)18% and concurrent radiochemotherapy were independent risk factors of radiation pneumonia(P0.05). [Conclusion ] Underlying chronic lung disease would increase the risk of radiation pneumonia in patients with locally advanced NSCLC undergoing radiotherapy,which indicating that the radiation for the normal tissue volume should be strictly controlled(V_(20)≤25% and V_(30)≤18%).
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