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Objective To explore the relative factors of radiation pneumonia(RP) in patients with lung cancer after radiotherapy,and find predictors of reasonable.Methods 98 cases received radical radiotherapy of non-small cell lung cancer patients were included,prescription dose of 60-68 Gy,clinical symptoms,chest X-ray,HRCT were used to detect RP.The clinical factors and treatment parameters were collected.Analysis of univariate and multivariate were used for chnical data and treatment planning indicators,assessment of RP related factors.Results 26 cases (26.53 ％) were RP in 2 above (≥2).The univariate anaiysis revealed that many parameteers (chronic obstructive pulmonary disease,whether chemotherapy,tumor volume,V20,V25,V30) were significantly associated with RP (x2 =12.253,x2 =8.802,t =3.758,t =3.432,t =3.210,t =3.190,P ＜ 0.05).Multivariate analysis revealed that COPD and V20＞25 ％,V30＞18 ％ were associated with RP (x2 =4.17,24.18,3.56,P =0.045,0.041,0.000).Conclusion Lung V20,V30,patients with chronic lung disease are the independence of the influencing factors of RP.In patients with chronic obstructive pulmonary disease the dose of normal tissue should be strictly controled,V20 ≤ 25 ％,V30 ≤ 18 ％.
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A 69-year old female patient was admitted because of 3 days of worsened chest pain.Coronary angiography showed60% stenosis of distal left main stem,chronic total occlusion of left anterior descending (LAD),70% stenosis at the ostium of a smallleft circumflex,70-90%stenosis at the paroxysmal and middle part of a dominant fight coronary artery (RCA),and a normal left internalmammary artery (LIMA) with normal origination and orientation.Percutaneous intervention was attempted but failed on the occludedlesion of LAD.The patient received minimally invasive direct coronary artery bypass (MIDCAB) with left LIMA isolation by Davincirobot.Eleven days later,the RCA lesion was treated by Sirolimus Rapamicin eluting stents implantation percutaneously.Then thepatient was discharged uneventfully after 3 days hospitalization.Our experience suggests that two stop shops of hybrid technique befeasible and safe in the treatment of elderly patient with multiple coronary diseases.
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Objectives:To report the clinical experience of combined interventional procedures in the treatment of elderly patients with coexisting two or more cardiovascular diseases in our medical center, and to assess the feasibility, safety and therapeutic efficacy of this management strategy. Methods : Patients were selected to the study if: 1) age ＞65 years; 2) with coexistence of two or more cardiovascular diseases which are indications for interventional therapy; 3) patients' general condition and organ functions allow the performance of combined multiple procedures; 4) the predicted procedure time is within 150 min; 5) the predicted contrast medium dosage is within 300 ml. The criteria we analyzed included procedural type, rocedural time, fluoroscopy time, dosage of contrast medium, success rates of the procedures, complications and in-hospital mortality. All patients were followed up for 30.4 ± 9.3 months,to determine the all-cause mortality, recurrence rates and adverse cardiac events. Results : From January 2000 to December 2004,combined interventional procedures were performed on 136 patients, with 2 procedures on 134 patients and 3 procedures on 2 patients.The mean procedure time was 115.4±11.6 min, the mean fluoroscopy time was 35.7±9.3 min, and the mean dosage of contrast medium used was 183.6±19.4 ml. Procedural success rate was 100%, no procedure related death or major complications occurred.Conclusion: Performed by a competent team, combined interventional procedures in elderly patients with multiple cardiovascular diseases were feasible and relatively safe.