T_(1-2)N_(0-1)M_0期乳腺癌保乳术后大分割调强放疗近期临床观察  

The retrospective study of hypofractionated intensity-modulated radiotherapy in breast cancer after breast conserving surgery with stage T_(1-2)N_(0-1)M_0

作　　者：景娜[1] 王玉[1] 杨君[2] 王仙玲[1] 马永强[1] 

机构地区：[1]山西省肿瘤医院乳腺放疗科,山西太原030013 [2]山西省肿瘤医院乳腺外科一病区,山西太原030013

出　　处：《现代肿瘤医学》2015年第22期3252-3255,共4页Journal of Modern Oncology

摘　　要：目的:观察T1-2N0-1M0期乳腺癌保乳术后大分割调强放疗的疗效、美容效果及不良反应。方法:选择2011年11月-2012年11月间就诊于山西省肿瘤医院乳腺疾病诊治中心的乳腺癌保乳患者41例,予大分割调强放疗,全乳计划靶体积43.5Gy/15次,瘤床区电子线补量8.7Gy/3次,2.9Gy/次,5次/周,疗程共24天。局部区域控制率和总生存率用Kaplan-Meier法计算。结果:中位随访时间27个月,随访率100%。3年局部区域控制率、生存率均为100%,急性放射性皮肤反应Ⅰ级4例,Ⅱ级3例;血液系统不良反应白细胞下降Ⅰ级5例,Ⅱ级3例,Ⅲ级2例;急性放射性肺炎I级2例,晚期放射性肺炎1例;患肢水肿轻度2例。放疗前、后美容效果评价优秀+良好率为95.1%、87.8%,放疗后1、3、6、12个月优秀+良好率均为90.2%。结论:早期乳腺癌保乳术后调强大分割放疗疗效和美容效果较好,且不良反应发生率低,可以缩短放疗时间。Objective： To observe the efficacy,cosmetic outcome and adverse reaction of hypofractionated intensity-modulated radiotherapy for T1-2N0-1M0 breast cancer after breast conserving surgery. Methods： From November2011 to November 2012,41 patients with T1-2N0-1M0 breast cancer after breast conserving surgery in Shanxi Tumor Hospital were enrolled in the trial. The hypofractionated intensity-modulated radiotherapy was applied to each patient. The hypofractionated intensity-modulated radiotherapy was 43. 5Gy /（ 15 f ·3w） to the whole breast,with a boost of 8. 7Gy /（ 3f·3d） to the tumor bed. The dose was 2. 9Gy per fraction,the total course of treatment was 24 days. Locoregional control and overall survival were calculated by Kaplan-Meier method. Results： The follow-up rate was 100%,the 3-year locoregional control and overall survival were both 100%. 4 developed grade Ⅰ acute radiodermatitis,3 developed grade Ⅱ acute radiodermatitis,5 developed grade Ⅰ leukocyte reduction,3 developed grade Ⅱ leukocyte reduction,2 developed grade Ⅲ leukocyte reduction,2 developed grade Ⅰ acute radioactive pneumonia,1 developed grade late radioactive pneumonia,2 developed grade Ⅰ limb edema. The excellent and good rates of cosmetic outcomes before and after radiotherapy were 95. 1%,87. 8%,The 1-,3-,6-,12-month excellent and good rates of cosmetic outcomes after radiotherapy were 90. 2%. Conclusion： The hypofractionated intensity-modulated radiotherapy for the patients with early-stage breast cancer after breast-conserving surgery have good therapeutic effects and cosmetic results,acceptable toxicities,low adverse reaction,as well as can shorten the time of radiotherapy.

关 键 词：乳腺肿瘤 外科学 大分割调强放疗 美容效果 疗效 不良反应 

分 类 号：R737.9[医药卫生—肿瘤]