乳腺癌保留乳房术后不同放疗模式近期临床观察  

Short-term results for different radiotherapy techniques in breast cancer patients after breast-conserving surgery

作　　者：郭莹[1] 乔学英[1] 宋玉芝[1] 李静[1] 周志国[1] 杨立鑫[1] 

机构地区：[1]河北医科大学第四医院放疗科,河北石家庄050011

出　　处：《中华肿瘤防治杂志》2013年第17期1340-1343,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：河北省卫生厅医学适用技术跟踪项目(GL2010-24)

摘　　要：目的:观察T1-2N0-1M0期乳腺癌保留乳房术后3种不同的放疗方式在近期疗效以及放疗毒副作用之间的差异。方法:全乳三维适形放疗+瘤床电子线76例(适形组),全乳调强放疗+瘤床电子线22例(调强组),同步整合推量调强放疗41例(同步整合推量组),观察3组的生存率、急性皮肤反应和美容效果。结果:全组中位随访时间31.3个月,至末次随访时间所有患者均生存。1、2、3级急性皮肤反应适形组分别为60例(78.9%)、14例(18.4%)和2例(2.7%),调强组分别为19例(86.4%)、3例(13.6%)和0;同步整合推量组分别为37例(90.2%)、4例(9.8%)和0,χ2=2.737,P=0.254。适形组、调强组和同步整合推量组美容效果评价良好者分别为49例(64.5%)、19例(86.4%)和32例(78.0%),χ2=5.087,P=0.079。适形组、调强组和同步整合推量组的放疗天数分别为(50.7±5.9)、(47.8±5.5)和(39.6±4.2)d,F=56.889,P<0.001。结论:乳腺癌保留乳房术后同步整合推量调强放疗拥有与三维适形放疗+电子线和调强放疗+电子线相似的生存率、急性皮肤反应及美容效果,且治疗时间较短。OBJECTIVE： To observe the toxicities and short-term efficacy of three different radiotherapy techniques in T1-2N0-1M0 breast cancer patients after breast-conserving surgery. METHODS： There were 76 patients receiving conventional three-dimensional conformal radiotherapy for the whole breast and electron boost to the tumor bed （3D-CRT group） ,22 patients receiving intensity-modulated radiotherapy for the whole breast and electron boost to the tumor bed （IMRT group）, 41 patients receiving simultaneous integrated boost intensity- modulated radiotherapy （SIB-IMRT group）. The survival time,acute skin toxicities and eosmesis were observed in three groups. RESULTS： The median follow-up was 31.3 months. To the last follow-up time,all patients were alive. The incidence of grade 1,2 and 3 acute skin toxicities was 78.9%（60/76）,18.4%（14/76） and 2.7% （2/76） respectively in 3D-CRT group;86.4% （19/22）,13.6% （3/22） and 0 respectively in IMRT group190.2% （37/41）, 9.8% （4/41） and 0 respectively in SIB-IMRT group. There was no statistical difference among the three groups （X2 = 2. 737, P=0. 254）. The patients with good cosmesis were 64.5%（49/76） in 3D-CRT group,86.4% （19/22） in IMRT group and in SIB-IMRT group 78.0% （32/41） respectively （X2= 5. 087 ,P=0. 079）. The average duration of radiotherapy was （50.7 ± 5.9） days in 3D-CRT group, （47.8 ± 5.5） days in IMRT group and （39.6 ± 4. 2） days in SIB-IMRT group respectively （F： 56. 889, P = 0. 001 ）. CONCLUSION： SIB-IMRT after breast-conserving surgery has similar survival rate, acute skin toxicities and cosmesis compared to 3D-CRT plus electron boost or IMRT plus electron boost and needs shorter treatment time. [

关 键 词：乳腺肿瘤 外科学 放射疗法 毒副作用 美容效果 

分 类 号：R737.9[医药卫生—肿瘤]