摘要
目的 探讨放射治疗胸部肿瘤尤其是左肺癌时对心脏的影响因素。方法 对 1983年 1月至 1984年 12月收治的胸部恶性肿瘤 44例 ,在放疗前、放疗中和放疗结束时分别作心电图检查。左肺癌 3 8例 ,右肺癌 2例 ,其他肿瘤 4例。常规野放疗 3 0例 ,大面积不规则野放疗 14例 ;加速超分割放疗 5例 ,大面积不规则野放疗 14例 ,常规野常规放疗 2 5例 ;<5 5Gy 19例 ,≥ 5 5Gy2 5例。结果 本组心电图异常发生率为 43 .2 % (19/44 ) ,其中心动过速 2 7.3 % ,心动过缓 4.5 % ,S T段下移 6.8% ,传导阻滞4.5 %。左下肺癌心电图异常率远远高于其他胸部肿瘤 (P <0 .0 1) ;≥ 5 5Gy组高于 <5 5Gy组 (P <0 .0 5 ) ;加速超分割照射组明显高于常规分割照射组 (P <0 .0 1)。结论 放射治疗期间可发生急性放射性心脏损伤 ,其损伤程度与心脏受照体积、放射剂量、分割方式有关。超分割、加速超分割照射胸部肿瘤尤其是左肺癌时应当慎重。
Objective To study the influence on the heart of radiotherapy in treatment of thoracic malignancies,especially the left lower lung cancer.Methods The ECG of 44 cases of thoracic malignancies from January,1983 to December,1984 were analysized retrospectively.All patients were given ECG examination at the beginning,midway and the end of radiotherapy.There were 38 cases of left lung cancer,2 cases of right lung cancer,and 4 cases of other thoracic malignancies.Among them,30 cases had been treated with routine field radiotherapy,14 cases with large irregular field radiotherapy.5 cases had been treated with hyperfractionated accelerated radiotherapy,14 cases with irregular large field radiotherapy,25 cases with routine field and routine radiotherapy.The radiotherapy doses were under 55 Gy in 19 cases,above 55 Gy or equal 55 Gy in 25 cases.Results The total incidence of abnormal ECG was 43.2%(19/44),in these,sinus tachycardia 27.3%,sinus bradycardia 4.5%,S T segment down 6.8%,conduct block 4.5%.The incidence rate of abnormal ECG in the patients with left lower lung cancer was higher than in others( P <0.01).It was higher in the patients with radiotherapy dose more than 55 Gy compared with in those with lower dose( P <0.05),and it was also higher in the patients with hyperfractionated accelerated radiotherapy compared with in those with routine radiotherapy( P <0.01).Conclusion During radiotherapy acute radiation heart injuries may happen.The degree of injuries is different,depending on the area of irradiation field, the dose of radiotherapy and the way of fraction.The author suggest that hyperfractionated radiation and hyperfractionated accelerated radiation should be cautiously used in treating thoracic malignancies,especially left lung cancer.
出处
《实用癌症杂志》
2001年第1期84-86,共3页
The Practical Journal of Cancer
