乳腺癌保乳术后化疗加调强放疗的疗效观察  

Clinical outcome of adjuvant chemotherapy pins intensity modulated radiotherapy after breast-conserving surgery

作　　者：木妮热·木沙江[1] 司马义力·买买提尼牙孜[1] 成芳[1] 艾秀清[1] 贺春钰[1] 朱相露[1] 木克代斯·拜克提亚尔[1] 许素玲[1] 刘浩[1] 张国庆[2] 阿布都沙拉木[3] 

机构地区：[1]新疆医科大学附属肿瘤医院放疗科, 新疆乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院胸外科, 新疆乌鲁木齐830011 [3]新疆医科大学附属肿瘤医院信息科, 新疆乌鲁木齐830011

出　　处：《中华放射肿瘤学杂志》2009年第6期463-465,共3页Chinese Journal of Radiation Oncology

摘　　要：目的观察Ⅰ、Ⅱ期乳腺癌保乳术后化疗加调强放疗的疗效及副反应。方法108例Ⅰ、Ⅱ期乳腺癌患者均行肿瘤扩大切除及腋窝淋巴结清扫的保乳术，大部分患者瘤床放置银夹标记。术后采用NE（诺维本＋表阿霉素）或TE（紫杉醇＋表阿霉素）或CEF（环磷酰胺＋表阿霉素＋氟尿嘧啶）方案化疗6周期。化疗后全乳接受调强放疗50Gy分25次，瘤床电子线补量10Gy分5次。ER／PR阳性的患者均给予三苯氧胺为主的内分泌治疗。结果随访截至2007年12月，随访率为100％，随访满1、2、3年的例数分别为108、88、58例。1、2、3年生存率分别为100％（108／108）、100％（88／88）、98％（57／58），局部复发3例；放疗期间出现不同程度的皮肤反应，乳房远期外观形状良好，未出现放射性肺炎、肺纤维化及心脏损伤等副反应。结论Ⅰ、Ⅱ期乳腺癌保乳术后化疗加调强放疗生存率高，复发转移少，副反应轻，达到了提高患者生存质量及局部控制率目的。Objective To evaluate the efficacy and side effects of adjuvant chemotherapy plus intensity modulated radiotherapy （IMRT） after breast-conserving surgery for stage Ⅰ and Ⅱ breast cancer. Methods After breast-conserving surgery, 108 patients received six cycles of chemotherapy followed by IM- RT. The irradiation dose of the whole breast was 50 Gy given by 25 fractions, followed by 10 Gy boost to the tumor bed given by 5 fractions with electron beams. Patients with positive estrone receptor or progesterone receptor were given endocrine treatment, mostly with tamoxifen. Results The follow-up rate was 100% by December 2007. The number of patients fallowed-up at 1-, 2- and 3-year was 108,88 and 58. The 1-, 2- and 3-year over survival rates were 100% , 100% and 98%. Three patients had local recurrence. Different degree of dermatitis occurred with good long-term cosmetic results. No severe side effects occurred such as radiation-induced pneumonitis, pulmonary fibrosis and heart injury. Conclusions Breast cancer patients treated by adjuvant chemotherapy plus IMRT after breast-conserving surgery have high survival rate and low side-effect rate. The survival quality and local control can be improved.

关 键 词：乳腺肿瘤/化学疗法 乳腺肿瘤/放射疗法 放射疗法 调强 预后 

分 类 号：R686[医药卫生—骨科学]