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目的研究非小细胞肺癌(NSCLC)患者在经过放射治疗后,出现有症状放射性肺损伤时的临床特点。方法选取2010年1月至2014年1月间接受放射治疗、并于治疗后出现有症状放射性肺损伤的63例非小细胞肺癌患者为研究对象。回顾性分析其各类临床表现,包括症状、体征、影像和血液学改变等。结果临床症状分级显示,2级肺损伤27例,患者3级肺损伤32例。4级1例,5级3例。症状出现距开始放疗平均(8.2±0.7)周。临床症状主要表现为咳嗽62例,气短43例,发热29例。临床体征以呼吸音粗糙为主,占30例。影像变化主要为肺实变、通气支气管征、斑片和条索影,多出现在放射野内,仅有4例出现在放射野之外。血液学改变主要表现为中性粒细胞数量升高,平均为(78.5±3.5)%。结论有症状放射性肺损伤主要发生在放射治疗后8周左右,临床特征较为显著,需要医护人员积极注意。
Objective To investigate the clinical features of patients with non-small cell lung cancer (NSCLC) after radiotherapy for symptomatic radiation-induced lung injury. Methods Sixty-three non-small cell lung cancer patients with radiation-induced lung injury who were treated with radiotherapy between January 2010 and January 2014 were selected as the study subjects. Retrospective analysis of its various clinical manifestations, including symptoms, signs, imaging and hematological changes. Results The clinical symptom grade showed 27 grade 2 lung injury and 32 grade 3 lung injury. 4 cases in 1 case, 5 cases in 3 cases. Symptoms appeared on average from the initial radiotherapy (8.2 ± 0.7) weeks. Clinical symptoms mainly manifested as cough in 62 cases, shortness of breath in 43 cases, fever in 29 cases. The main clinical signs of rough breathing sounds, accounting for 30 cases. Changes in the main image of lung consolidation, bronchial signs of ventilation, patch and cable shadow, mostly in the radiation field, only 4 cases appeared outside the radiation field. Hematological changes mainly manifested as an increase in the number of neutrophils, with an average of (78.5 ± 3.5)%. Conclusions Symptomatic radiation-induced lung injury mainly occurs at about 8 weeks after radiotherapy. The clinical features are more significant and require positive attention from medical staff.