在放射治疗期间,光子和质子肺癌患者的呼吸反应的每周变化
medRxiv : the preprint server for health sciences
|September 5, 2025
概括
在放射治疗期间肺呼吸的早期变化预示着后来的变化. 早期增加呼吸可能表明患有肺炎的风险较高,需要进一步研究.
科学领域:
- 辐射瘤学
- 肺部医学
- 医学成像
背景情况:
- 质子辐射疗法可能会降低正常组织的毒性,例如辐射诱导的肺炎.
- 这些益处的临床实现是有限的.
- 基于Voxel的正常组织评估,包括通风映射,可以进一步调查剂量毒性关系.
研究的目的:
- 调查早期的肺通风变化是否预测治疗结束时的通风变化.
- 将通风变化与辐射剂量和临床因素相关联.
- 开发治疗结束通风的预测模型.
主要方法:
- 对肺癌患者 (光子和质子疗法) 在计划时,一周 (WK1) 和治疗结束时 (EOT) 创建了基于4DCT的通风图.
- 计算了Voxel的通风变化,并按剂量进行了分析.
- 用线性回归模型预测基于计划和WK1通风的EOT,并结合其他临床因素.
主要成果:
- 在光子和质子治疗中,WK1的通风变化显著预测了EOT的通风变化.
- 在WK1增加呼吸的患者在EOT (72- 80%) 呈现出相似的分层,并且更有可能发生2级+肺炎.
- 一个线性回归模型实现了R平方=0.65的预测准确度.
结论:
- 放射治疗早期的肺透气变化 (WK1) 预示着EOT的变化.
- 在早期治疗期间增加呼吸可能是发展肺炎的危险因素.
- 需要进一步的研究,以充分阐明通风变化与肺炎的发展之间的关系.
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