[临床医学]局部晚期非小细胞肺癌的同期放化疗进展-协和王绿化.ppt

Received Mar 8, 2012, and in revised form Apr 19, 2012. Accepted for publication Apr 29, 2012 Conclusion Patients undergoing CCRT for NSCLC, pneumonitis risk is associated with the type of chemotherapy regimen, dosimetric parameters, and patient age. Fatal pneumonitis is uncommon but is associated with large doses per fraction, large V20, and lower-lobe tumors. Further research is needed to evaluate methods to mitigate pneumonitis risk in patients undergoing curative-intent CCRT. Poor Baseline Pulmonary Function May Not Increase the Risk of Radiation Induced Lung Toxicity Jingbo Wang, M.D.; Jianzhong Cao, M.D. ; Shuanghu Yuan, M.D.; Wei Ji, M.D.; Douglas Arenberg, M.D.; Jianrong Dai, Ph. D.; Paul Stanton, B.A. ; Daniel Tatro; Randall K Ten Haken, Ph. D.; Luhua Wang, M.D.; Feng-Ming (Spring) Kong, M.D., Ph.D. Accepted by International Journal of Radiation Oncology*Biology*Physics Correlation between PFTs and ≥ G2 SRILT Logistic regression for analytical variables Individual based scatter plot indicates no linear correlation between MLD and FEV1. Conclusion Age and MLD were independently correlated with SRILT. Lower baseline pulmonary function did not increase the risk of SRILT and might even be associated with lower probability of SRILT, Which suggests that poor PFTs should not be a contraindication to definitive radiation therapy. FEV1 may help predicting the risk for SRILT. * Three Clinical Research Topics in Radiotherapy of Locally Advanced NSCLC 2、New Radiation Techniques: 3DRT，IMRT, IGRT, 4D RT 3、Normal Tissue Protection： Radiation Pneumonitis and Esophagitis * 谢谢 * 薛为忠 男 54岁 入院日期2011-1-5 961929 患者主因右侧胸背痛6月，咳嗽咳痰1月入院。2010-7月开始右侧胸背痛，VAS 2分。10-11月CT提示右肺上叶下叶各一结节，伴阻塞性炎症，右侧胸腔少量积液。支气管镜见右肺上叶支气管开口至右主支气管，右肺中间段支气管粘膜充血，病理提示鳞状上皮原位癌。 入院诊断：p右肺鳞癌 T2a N2 M0 IIIA期 右肺门、纵膈2R、4R淋巴结转移 治疗经过：同步放化，EP 2周期，IMRT 95% PTV 66Gy/33f * 在接近吸气末时开始屏气。屏气时长取决于患者肺功能、精神状态和是否接受了适当训练。经训练，屏气可到40s，甚至更长。屏气