摘要
Objective:Toanalyzetheinfluencingfactorsforradiation-inducedheartdisease(RIHD)inapanelofcaseswithmalignantthymictumorstreatedbyradiotherapy.Methods:52consecutivepatientsweretreatedbyradiotherapyformalignantthymictumor(14atMasaokastageII,23atstageIIIand15atstageIV).Treatmentincludedradical(in20),postoperative(in14),preoperative(in2)andpalliative(in16)radiotherapy.Theconventionaltwo-dimension(2D)radiationtherapywasperformedinforty-sevenpatientsandthree-dimension(3D)conformalradiationtherapyhasbeenusedin5patientssinceOctober2000.Thetotaltumordoserangedfrom10Gyto84.5Gy(medianof55Gy).Chemotherapywasgivenintwenty-fivepatientsbeforeorafterradiotherapy.Theresultsoffollowing-upcouldbeobtainedfromthedatabaseandupdatedwhereappropriated.Thedosevolumehistogram(DVH)ofheartinradiotherapyforallpatientswasanalyzedfortheeffectivevolumedoseofheart.Result:Themedianfollowing-upwas14months(rangedfrom0.6to111.3months)inthestudy.RIHDwasobservedinsevenpatients.CardiactoxicityofthesesevenpatientswereevaluatedasSOMAgrade1-3.Themediantwo-thirdeffectivevolumedoseofheartwas47.2Gy(rangedfrom8.3Gyto70.1Gy)forconventional2Dradiotherapy,whichcorrelatedwiththymictumordose(P<0.0001).Themediantwo-thirdeffectivevolumedoseofheartwas35.3Gy(rangedfrom13Gyto38.7Gy)for3Dconformalradiotherapy.Theeffectivevolumedosesofheartweredecreasedbyusing3Dconformalradiotherapy(P=0.048).Asignificantassociationbetweencardiactoxicityandeffectivevolumedoseofheartwasfoundinthisstudy(P<0.0001).Cardiactoxicityaccountedfor10.4%and4.1%ofpatientsreceivingandnotreceivingadjuvantchemotherapy,respectively,andoccurredearlierinradiochemotherapygroup(P=0.0528).Multivariateanalysissuggestedthatcardiactoxicitywassignificantlyinfluencedbytheeffectivevolumedoseofheartandchemotherapy.C
出版日期
2003年03月13日（中国期刊网平台首次上网日期，不代表论文的发表时间）
