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放疗在胸部肿瘤特别是肺癌患者中发挥着至关重要的作用,不管是早期不可手术切除肺癌的根治性治疗,还是可手术切除肺癌的联合治疗或者是晚期肺癌的姑息治疗,放疗都是重要的治疗方式之一[1-2]。然而辐射引起的放射性肺损伤又是胸部放疗最常见且最严重的剂量限制性不良反应,包括放射性肺炎和放射性肺纤维化,而放射性支气管炎在临床上并不常见,现将我院诊治的1例晚期肺癌患者经放疗后发生放射性支气管炎的结果结合文献复习报道如下。
肺癌放疗后致放射性支气管炎1例并文献复习
Radiation bronchitis after radiotherapy of lung cancer: a case report and literature review
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摘要: 笔者报道了1例左肺鳞癌放疗后发生放射性支气管炎的少见病例,该病例经电子支气管镜检查确诊并行支气管镜下介入治疗。笔者分析了放射性支气管炎发生的影响因素,内镜下的诊断及治疗情况,并进行了文献复习。通过对该病例的治疗,以期分享该类型病例内镜下诊断和治疗的经验。Abstract: The authors reported a rare case of radiation bronchitis after radiotherapy of left lung squamous cell carcinoma. The case was confirmed by electronic Bronchoscopy and treated by interventional bronchoscopy. The authors analyzed the influencing factors of radiation bronchitis, endoscopic diagnosis and treatment, and reviewed the literature. Through the treatment of this case, the authors hoped to share experience in endoscopic diagnosis and treatment of this type of case.
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[1] von Reibnitz D, Yorke ED, Oh JH, et al. Predictive modeling of thoracic radiotherapy toxicity and the potential role of serum alpha-2-macroglobulin[J/OL]. Front Oncol, 2020, 10: 1395[2022-11-01]. https://www.frontiersin.org/articles/10.3389/fonc.2020.01395/full. DOI: 10.3389/fonc.2020.01395. [2] 喻冰琪, 王谨, 徐裕金, 等. 放疗技术与放射性肺损伤: 高剂量小体积还是低剂量大体积?[J]. 中国肺癌杂志, 2015, 18(12): 752−757. DOI: 10.3779/j.issn.1009-3419.2015.12.07.
Yu BQ, Wang J, Xu YJ, et al. Radiotherapy techniques and radiation pneumonitis: a lot to a little or a little to a lot?[J]. Chin J Lung Cancer, 2015, 18(12): 752−757. DOI: 10.3779/j.issn.1009-3419.2015.12.07.[3] Tsujino K, Hashimoto T, Shimada T, et al. Combined analysis of V20, VS5, pulmonary fibrosis score on baseline computed tomography, and patient age improves prediction of severe radiation pneumonitis after concurrent chemoradiotherapy for locally advanced non-small-cell lung cancer[J]. J Thorac Oncol, 2014, 9(7): 983−990. DOI: 10.1097/JTO.0000000000000187. [4] Harder EM, Park HS, Chen Z, et al. Pulmonary dose-volume predictors of radiation pneumonitis following stereotactic body radiation therapy[J]. Pract Radiat Oncol, 2016, 6(6): e353−e359. DOI: 10.1016/j.prro.2016.01.015. [5] Bielopolski D, Evron E, Moreh-Rahav O, et al. Paclitaxel-induced pneumonitis in patients with breast cancer: case series and review of the literature[J]. J Chemother, 2017, 29(2): 113−117. DOI: 10.1179/1973947815Y.0000000029. [6] Antonia SJ, Villegas A, Daniel D, et al. Durvalumab after chemoradiotherapy in stage Ⅲ non-small-cell lung cancer[J]. N Engl J Med, 2017, 377(20): 1919−1929. DOI: 10.1056/NEJMoa1709937. [7] Kong FMS, Wang SL. Nondosimetric risk factors for radiation-induced lung toxicity[J]. Semin Radiat Oncol, 2015, 25(2): 100−109. DOI: 10.1016/j.semradonc.2014.12.003. [8] Ren CB, Ji TL, Liu TT, et al. The risk and predictors for severe radiation pneumonitis in lung cancer patients treated with thoracic reirradiation[J/OL]. Radiat Oncol, 2018, 13(1): 69[2022-11-01]. https://ro-journal.biomedcentral.com/articles/10.1186/s13014-018-1016-z. DOI: 10.1186/s13014-018-1016-z. [9] Zhao J, Yorke ED, Li L, et al. Simple factors associated with radiation-induced lung toxicity after stereotactic body radiation therapy of the thorax: a pooled analysis of 88 studies[J]. Int J Radiat Oncol Biol Phys, 2016, 95(5): 1357−1366. DOI: 10.1016/j.ijrobp.2016.03.024. [10] Jin HK, Tucker SL, Liu HH, et al. Dose-volume thresholds and smoking status for the risk of treatment-related pneumonitis in inoperable non-small cell lung cancer treated with definitive radiotherapy[J]. Radiother Oncol, 2009, 91(3): 427−432. DOI: 10.1016/j.radonc.2008.09.009. [11] Inoue T, Shiomi H, Oh RJ. Stereotactic body radiotherapy for stage Ⅰ lung cancer with chronic obstructive pulmonary disease: special reference to survival and radiation-induced pneumonitis[J]. J Radiat Res, 2015, 56(4): 727−734. DOI: 10.1093/jrr/rrv019. [12] Ozawa Y, Abe T, Omae M, et al. Impact of preexisting interstitial lung disease on acute, extensive radiation pneumonitis: retrospective analysis of patients with lung cancer[J/OL]. PLoS One, 2015, 10(10): e0140437[2022-11-01]. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0140437. DOI: 10.1371/journal.pone.0140437. [13] 涂莉佳, 郑泰浩, 廖荣鑫, 等. 肺癌患者放射性肺损伤相关危险因素的研究进展[J]. 重庆医学, 2022, 51(7): 1224−1229. DOI: 10.3969/j.issn.1671-8348.2022.07.029.
Tu LJ, Zheng TH, Liao RX, et al. Research progress on risk factors associated with radiation-induced lung injury in lung cancer patients[J]. Chongqing Med, 2022, 51(7): 1224−1229. DOI: 10.3969/j.issn.1671-8348.2022.07.029.[14] Speiser BL, Spratling L. Radiation bronchitis and stenosis secondary to high dose rate endobronchial irradiation[J]. Int J Radiat Oncol Biol Phys, 1993, 25(4): 589−597. DOI: 10.1016/0360-3016(93)90003-e. [15] Taulelle M, Chauvet B, Vincent P, et al. High dose rate endobronchial brachytherapy: results and complications in 189 patients[J]. Eur Respir J, 1998, 11(1): 162−168. DOI: 10.1183/09031936.98.11010162. [16] Lee SJ, Lee JY, Jung SH, et al. A case of radiation bronchitis induced massive hemoptysis after high-dose-rate endobronchial brachytherapy[J]. Tuberc Respir Dis, 2012, 73(6): 325−330. DOI: 10.4046/trd.2012.73.6.325. [17] 唐飞, 吕莉萍, 叶伟, 等. 支气管镜下介入治疗放射性气管支气管炎的临床疗效[J]. 安徽医学, 2017, 38(12): 1585−1587. DOI: 10.3969/j.issn.1000-0399.2017.12.025.
Tang F, Lyv LP, Ye W, et al. Clinical effect of interventional treatment of radiation tracheobronchitis under bronchoscope[J]. Anhui Med J, 2017, 38(12): 1585−1587. DOI: 10.3969/j.issn.1000-0399.2017.12.025.