The Correlation Between Dosimetric Factorsandacuteradiation-Induced Lung Injurywith IMRT In Lung Caner Based Ondifferent Lesion Location

Objective:to explore The Correlation between dosimetric factors and acute radiation-induced lung injury with IMRT in lung caner based on different lesion location.Method:113 patients with lung cancer accepted less field IMRT were analysised.We retrospectively reviewed the clinical and radiation data,explore the correlation with ARP.RTOG standard were used to classify the ARP gradeS,statistical methods were univariate analysis and multivariate analysis was used to select the most significant factor.Then using ROC curve to selecting the best threshold of predictors.Results:By univariate analysis and multivariate analysis, diseased side’s V5 ((X2=5.783, P=0.016)) is an independent predictor of grade>2 ARP occurred,and the best threshold of 71.6%(AUC=0.859,P=0.00) and 59.47% (AUC=0.73,P=0.04) for not been postoperativeo. According to lesion location grouping analysis, rV5 for right lung (P=0.02), upper right lung (P=0.02), right middle/inferior lung (P=0.049) is an independent predictor of grade>2 ARP occurred. The best threshold were 66.19%, AUC= 0.915, P=0.001),74.67%(AUC=0.933, P=0.016),87.49%(AUC=0.777, P =0.117). aV5 for lung cancer of mediastinal type is an independent predictor of acute radioactive lung injury (P=0.009),with threshold 66.73 (AUC=0.889, P =0.889).Conclusion:Diseased side’s V5is an independent predictor of grade>2ARP occurred. Based on the different lesion location, rVs is independent prognostic factor of right lung, upper right lung, right middle/inferior lung, and aV5 for mediastinal type independent prognostic factor.