Study On The Establishment And Application Of The PI Forecasting Model For Radiation Induced Lung Injury

Objective:By the analysis of the clinical data,radiotherapy data and prognosis data,and serum cytokines detection in NSCLC patients,picking out the factors associated with radiation induced lung injury.And establish a PI forecasting model using to predict radiation induced lung injury.Methods:120 NSCLC patients from the radiotherapy department in Tianjin Cancer Hospital,was recorded from 2008.3.18 to 2008.8.5.And the follow up time is to 2009.3.18.These factors were designed in a table.1.General clinical data.Including:age,sex,KPS score,smoking or not,primary disease in lung,diagnosis time,primary symptom,the tumor location,pathology types,clinical staging,radiotherapy method,treatment Taxinol using,pulmonary function index and so on.Blood sample were collected at the time of before radiation,in radiation at 30-40Gy,and 3 months after radiation.The cytokines such as IL-1,IL-6,TGF-β1,ACE,were detected.By the analysis of the radiotherapy program and DVH graph,get the date associated with,the V5,V10,V15,V20,MLD,PTV MLD,and the total dose and fraction.According to the CTC AE 3.0,RTOG acute lung pneumonia criteria,Grade 2 or worse lung injury was used as end point.Results:1.The development of the radiation lung therapy.There were 120 cases,the follow-up time was to Month 18th,2009.The middle time was 10 months,from 8month to 12month.we had a evaluation at 3month and 6 months.There were 39 cases to happen the injury.Among the total,18 cases is grade 1,12cases is grade 2,7cases is grade 3,2cases was grade 4.There were 21 cases≥2 cases.The incidence rate was 17.5%, and there were two cases died for other reasons. The statistics analysis show that,chemotherapy,Taxinol using,lung function IL-6,TGF-β1,V5,V20,V10,were associated with injury.PI forest model:PI=h(t,x)=h0(t)exp(1.138X1+2.833X2+1.025X3)When V5≥51%,the risk increase 1.12 times by the 1%increase.When V20≥25%,the risk increase 1.999 times by the 1%increase.The IL-6 6ng/ml, and P=0.040.the risk increase 2.049 times by the 1ng/ml increase.Conclusions:1,radiotherapy lung injury was developed by all kinds of factors.Taxinol using chemotherapy and the lung function was important before radiotherapy.V5 was more important in the early injury.and the V20 was important in the late injury.when we designing a program,we should pay attention to V5,V20 and MLD.And the special character in different patients should be individed.PI foresting model should be proofed at the following research.