早期乳腺癌保乳术后大分割调强放疗的近期疗效观察  

Clinical effects of central hypofractionated intensity modulated radiotherapy on patients with early stage breast cancer after breast-conserving surgery

作　　者：王义海 曹茜[1] 贺春钰[1] 木妮热·木沙江[1] Wang Yihai;Cao Qian;He Chunyu;Munnire·Mshajiang(Department of Radiation Oncology,the Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学附属肿瘤医院乳腺放疗科,乌鲁木齐830011

出　　处：《山西医药杂志》2018年第1期7-9,共3页Shanxi Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(2017D01-C378);新疆医科大学创新基金(XYDCX2015)

摘　　要：目的观察早期乳腺癌保乳术后采用大分割调强放疗的近期疗效、不良反应和美容效果。方法2014年6月至2015年3月保乳术后行调强放疗的37例pTis-2N0M0期乳腺癌患者。全乳42.56Gy/16次,瘤床补量10Gy/次,总疗程29d。局部区域控制率和总生存率用Kapian-Meier法计算。结果随访率100%。2年局部区域控制率、生存率均为100%;上肢水肿6例;1、2级放射性肺炎分别为3、2例;美容效果满意率占92%;与同期保乳术后常规分割放疗相比,放疗次数由30次降至21次,疗程由42d缩短至29d,费用由30 375元降至19 575元。结论乳腺癌保乳术后全乳三维调强大分割放疗组患者选择恰当,局部控制、不良反应和美容评价初步结果较好,且能显著降低治疗时间和费用。Objective To observe the therapeutic effects,cosmetic results,and toxicities of central hypofractionated intensity modulated radiotherapy for patients with early-stage breast cancer after breast-conserving surgery.Methods From June 2014 to March 2015,37 patients with pTis-2N0M0 breast cancer after breast-conserving surgery were enrolled in the trial.Intensity modulated conformal radiotherapy or simplified intensity modulated radiotherapy was applied to each patient.The hypofractionated radiotherapy schedule was 42.56 Gy/16 fractions to the whole breast.With a boost of 10 Gy/5 fractions to the tumor bed.The total course of treatment was 29 days.Locoregional control and overall survival were calculated by Kaplan-Meier method.Results The follow-up rate was 100%.The 2-year local regional control and overall survival were both 100%,and 6 developed grade 2 upper extremity edema,3 developed grade 1 radiation pneumonitis,and 2 developed grade 2 radiation pneumonitis.Compared with the conventional fractionated radiotherapy for the patients with early-stage breast cancer after breast-conserving surgery,the hypofractionated intensity modulated radiotherapy had the number of fractions radiotherapy decreased from 30 to 21.Course of treatment shortened from 42 days to 29 days.and the cost cut from￥30 375 to￥19 575.Conclusion The central hypofractionated intensity modulated radiotherapy for the patients with early-stage breast cancer after breast-conserving surgery have good therapeutic effects and cosmetic results and acceptable toxicities,and it as well significantly reduced time and cost of treatment.

关 键 词：乳腺肿瘤 外科学 保乳术 乳腺肿瘤/放射疗法 放射疗法 大分割放疗 

分 类 号：R737.9[医药卫生—肿瘤]