早期乳腺癌保乳术后瘤床序贯加量与同期加量放疗的随机对照研究  

A Randomized Controlled Study of Sequential Boost Radiotherapy and Simultaneous Integrated Boost Radiotherapy in Early Patients After Breast Conserving Surgery

作　　者：于波[1] 顾小伟[1] 舒忠琴[1] 沙莎[1] 周菊英[2] 王利利[2] YU Bo;GU Xiao-wei;SHU Zhong-qin;SHA Sha;ZHOU Ju-ying;WANG Li-li(Radiation Oncology Center,Jiangsu Jiangyin People's Hospital,Jiangyin,Jiangsu,214400,China;Deparment of Radiation Oncology,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]江苏省江阴市人民医院放疗中心,江苏江阴214400 [2]苏州大学附属第一医院放疗科,江苏苏州215006

出　　处：《中国血液流变学杂志》2018年第2期138-141,共4页Chinese Journal of Hemorheology

基　　金：国家自然科学基金资助项目(81402627).

摘　　要：目的比较早期乳腺癌保乳术后瘤床序贯加量和同期加量两种放射治疗技术的疗效、副反应及美容效果。方法2014年1月-2017年5月江阴市人民医院收治的早期乳腺癌保乳术后患者96例。随机分为两组,其中瘤床序贯加量放疗组(序贯组)49例,同期加量放疗组(同期组)47例。序贯组剂量分割方式为全乳50 Gy/25次/5周,后续瘤床序贯加量10~16Gy/5~8次/1~1.5周;同期组剂量分割方式为全乳50 Gy/25次/5周,瘤床60Gy/25次/5周。比较两组患者的治疗副作用、美容效果和长期生存。结果序贯组与同期组急性皮肤反应发生率、晚期皮肤反应发生率、骨髓抑制发生率、放射性肺炎发生率比较,差异均无统计学意义(P>0.05)。放疗前、放疗后、放疗1年后的序贯组与同期组美容优良率比较,差异均无统计学意义(P>0.05)。随访12~50个月,中位随访时间为29个月,随访率为100%,随访期间全组患者均健康存活。结论保乳术后瘤床序贯加量和同期加量的疗效相似,美容效果相当且未加重早晚期不良反应,并有缩短疗程的优势。Objective To compare the clinical effects, side effects and cosmetic effects of two radiotherapy techniques sequential boost radiotherapy and simultaneous integrated boost radiotherapy after breast conserving surgery for early breast cancer. Methods From January 2014 to May 2017 in Jiangyin People's Hospital, 96 patients with early breast cancer after breast conserving surgery were included in this study. The patients were randomly divided into sequential boost radiotherapy group (49 cases) and simultaneous integrated boost radiotherapy group (47 cases). In sequential boost radiotherapy group, 49 patients received 25 fractions of 2.0 Gy for the total breast during 5 weeks following 5~8 fractions of 2.0 Gy for local tumor bed in 1~1.5 weeks. In simultaneous integrated boost radiotherapy group, 47 patients received 25 fractions of 2.0 Gy for the total breast and 2.4 Gy for local tumor bed during 5 weeks. We investigated the side effects, cosmetic effects and long-term survival. Results The incidence rates of acute skin reaction, late skin reaction, bone marrow suppression and radiation pneumonia were not statistically significant between the sequential boost radiotherapy group and simultaneous integrated boost radiotherapy group (P>0.05). No significant differences were observed in terms of cosmetic effect between the sequential boost radiotherapy group and simultaneous integrated boost radiotherapy group before, after and 1 year after radiotherapy (P>0.05). Patients were followed up for 12 to 50 months. The median follow-up time was 29 months and the follow-up rate was 100%. All patients were healthy and survived during the follow-up period. Conclusion The efficacy of sequential boost radiotherapy was similar to that of simultaneous integrated boost radiotherapy after breast conserving surgery for early breast cancer. The simultaneous integrated boost radiotherapy is acceptable with similar cosmetic effect from that sequential boost radiotherapy for early patients after breast conserving surgery, and the treatment

关 键 词：乳腺癌 保乳术 瘤床 同期 序贯 

分 类 号：R737.9[医药卫生—肿瘤] R730.55[医药卫生—临床医学]