乳腺癌改良根治术后胸壁加锁骨野常规放疗与三维适形放疗的疗效及安全性分析  

Efficacy and safety of conventional radiotherapy of chest wall and clavicular field and three-dimensional conformal radiotherapy in patients after modified radical mastectomy

作　　者：王松林[1] 潘金华[1] 童武松[1] WANG Song-lin PAN Jin-hua TONG Wu-song(Department of Oncology , People＇s Hospital of Zhongxiang City, Zhongxiang City 431900, Hubei Provinvce China)

机构地区：[1]湖北省钟祥市人民医院肿瘤科,湖北钟祥431900

出　　处：《海南医学院学报》2017年第4期539-541,545,共4页Journal of Hainan Medical University

基　　金：湖北省钟祥市科学技术支撑项目(0910108144)~~

摘　　要：目的:探讨乳腺癌改良根治术后胸壁加锁骨野常规放疗与三维适形放疗的疗效及安全性。方法:选取我院收治的乳腺癌改良根治术后患者84例,根据术后放疗方式的不同分为常规放疗组(42例)及三维适形放疗组(42例),常规放疗组进行胸壁加锁骨野常规放疗,三维适形放疗组行三维适形放疗。于治疗6~8周后检测两组血清肿瘤标志物水平及外周血T淋巴细胞亚群变化,并分析两组临床疗效及毒副反应。结果:两组治疗后血清CA15-3、CA125、CEA、CK19水平与治疗前比较均明显降低(P<0.05),CD3^+、CD4^+、CD4^+/CD8^+较治疗前明显升高,CD8^+明显降低(P<0.05),但组间治疗后比较无统计学差异(P>0.05);常规放疗组治疗后放射性皮肤损伤、放射性肺炎发生率明显高于三维适形放疗组(P<0.05)。结论:两种放疗方案疗效相当,但三维适形放疗毒副反应明显低于常规放疗方案,具有一定优势。Objective：To explore the efficacy and safety of conventional radiotherapy of chest wall and clavicular field and three-dimensional conformal radiotherapy in patients after modified radical mastectomy.Methods：A total of 84 patients who were admitted in our hospital after modified radical mastectomy were included in the study and divided into the conventional radiotherapy group（n=42）and the three-dimensional conformal radiotherapy group（n=42）according to different radiotherapy methods.The patients in the conventional radiotherapy group were given conventional radiotherapy of chest wall and clavicular field,while the patients in the three-dimensional conformal radiotherapy group were given three-dimensional conformal radiotherapy.The serum tumor markers and peripheral blood T lymphocyte subsets 68weeks after treatment in the two groups were detected.The clinical efficacy,and toxic and side effects in the two groups were evaluated.Results：The serum CA15-3,CA125,CEA,and CK19 levels after treatment in the two groups were significantly reduced when compared with before treatment（P〈0.05）,CD3＋,CD4＋,and CD4＋/CD8＋were significantly elevated,while CD8＋was significantly reducedwhen compared with before treatment（P〈0.05）,but the comparison of the above indicators between the two groups was not statistically significant（P〈0.05）.The occurrence rate of radioactive skin damage and pneumonia after treatment in the conventional radiotherapy group was significantly higher than that in the three-dimensional conformal radiotherapy group（P〈0.05）.Conclusions：The two kinds of radiotherapy schemes have an equal efficacy,but the toxic and side effects of three-dimensional conformal radiotherapy are significantly lower than those by the conventional radiotherapy,with a certain advantage.

关 键 词：乳腺癌 常规放疗 三维适形放疗 肿瘤标志物 T淋巴细胞亚群 

分 类 号：R737.9[医药卫生—肿瘤]