CHANGES IN LUNG-FUNCTION AND PERFUSION AFTER IRRADIATION IN PATIENTS WITH LUNG-CANCER
CHANGES IN LUNG-FUNCTION AND PERFUSION AFTER IRRADIATION IN PATIENTS WITH LUNG-CANCER
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DOI：
10.1016/0169-5002(94)90283-6
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发表时间：
1994-07-01
期刊：
影响因子：
5.3
通讯作者：
WILLCOX, PA
中科院分区：
文献类型：
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作者：
ABRATT, RP;WILLCOX, PA
对接受相对高剂量照射的肺癌患者肺功能的变化进行了前瞻性研究。在就诊时、照射后 5 至 6 个月（第 1 组，36 名可评估患者）再次测量他们的呼吸困难评分、肺活量测定、弥散能力和同侧半胸灌注，并在 11 至 12 个月期间再次测量（第 2 组，16 名可评估患者）。大部分患者的呼吸困难评分从 1 分恶化为 2 分，但只有 6% 的患者呼吸困难评分为 3 分。肺功能测试的最大变化是弥散能力 (DLCO) 在 6 个月时下降至 14%，在 12 个月时下降至 12%（统计学显着，P < 0.0001 配对 t 检验）。用力肺活量（FVC）和总肺活量（TLC）在6个月和12个月时下降幅度较小，下降幅度最小的是1秒用力呼气量（FEV1），但没有统计学意义。 6 个月时同侧半胸肺灌注显着下降 16%，12 个月时下降 20%。随访时 DLCO 下降与 FEV1 之间存在微弱相关性。初始灌注或灌注减少与肺功能下降之间没有统计学上显着的相关性。肺。对于预计生存期为 6 个月或以上的患者，放射治疗应被视为一种类似于手术的消融治疗方式。 DLCO 是临床损伤最敏感的指标，其治疗前评估应有助于预测临床对辐射的耐受性。
The changes in lung function were prospectively studied for patients with lung carcinoma who were treated with relatively high doses of irradiation. Their dyspnoea score, lung volume spirometry, diffusion capacity and ipsilateral hemithorax perfusion were measured at presentation, again between 5 and 6 months after irradiation (Group 1, 36 evaluable patients), and once more between 11 and 12 months (Group 2, 16 evaluable patients). There was a worsening of the dyspnoea score from 1 to 2, in a large percentage of patients, but only 6% developed a dyspnoea score of 3. The largest change in lung function tests was a decrease in the diffusion capacity (DLCO) to 14% at 6 months and 12% at 12 months (statistically significant, P < 0.0001 paired t-test). The forced vital capacity (FVC) and the total lung capacity (TLC) showed a lesser decrease at 6 and 12 months, and the smallest decrease, which was not statistically significant, was in the forced expiratory volume in 1 s (FEV1). There was also a statistically significant decrease in the ipsilateral hemithorax lung perfusion of 16% at 6 months and 20% at 12 months. There was a weak correlation between the decrease in the DLCO and the FEV1 at follow-up. There was no statistically significant correlation between initial perfusion or decreased perfusion and the decrease in lung function. Lung. irradiation should be regarded as an ablative form of therapy, analogous to surgery, in patients with a projected survival of 6 months or more. The DLCO is the most sensitive indicator of clinical damage and its pretreatment assessment should be useful in predicting clinical tolerance to irradiation.