保乳术后两种不同剂量分割放疗的初期疗效对比  

Comparison of Two Different Fractionated Radiotherapy After Breast Conserving Surgery

作　　者：章朝阳 卓霞 辛培玲[1] 张玲玲[1] 何丽红 王青兰[2] ZHANG Chaoyang;ZHUO Xia;XIN Peiling;ZHANG Lingling;HE Lihong;WANG Qinglan(Department of Radiotherapy,First Hospital of Quanzhou Affiliated to Fujian Medical University,Quanzhou Fujian 362000,China;Breast Surgery,First Hospital of Quanzhou Affiliated to Fujian Medical University,Quanzhou Fujian 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院放疗科,福建泉州362000 [2]福建医科大学附属泉州第一医院乳腺外科,福建泉州362000

出　　处：《中国卫生标准管理》2020年第20期61-64,共4页China Health Standard Management

摘　　要：目的对比早期乳腺癌患者保乳术后全乳腺放疗瘤床同期推量的大分割调强放疗与常规分割调强放疗的初期临床疗效及安全性。方法收集2017年6月—2018年12月我院诊治的分期为pT1-2N0M0的早期浸润性乳腺癌保乳术后患者共70例,随机分为大分割放疗组和常规分割组(各35例)。其中,大分割放疗组采用全乳腺放疗瘤床同期推量大分割的调强放疗,全乳腺PCTV 40.5 Gy/15次/3周,瘤床PGTV-tb 48.0 Gy/15次/3周;常规分割放疗组为常规分割调强放疗,全乳腺PCTV 50.0 Gy/25次/5周,序贯瘤床加量PGTVtb 10 Gy/5次/1周,总疗程6周。对比两组的局部控制率、1年生存率、放疗毒副反应发生率及以美容效果。结果随访1年,大分割放疗组和常规分割放疗组的局部控制率、1年生存率均为100%,均无复发或死亡病例。两组放疗相关毒副反应如血液毒性不良反应发生率、≤2级急性、晚期皮肤不良反应率比较无差别(均P>0.05),两组放疗后1、6个月美容效果优良率相似(P>0.05),但相比于常规分割放疗组,大分割放疗组的治疗费用便低、住院时间便短(P<0.05)。结论全乳腺放疗瘤床同期加量的大分割调强放疗较常规分割调强放疗的近期疗效相似,且减少患者治疗费用、缩短住院时间,未增加放疗毒副反应。Objective To compare the clinical efficacy and safety of hypofractionated modulated radiotherapy and conventional radiotherapy for early-stage breast cancer patients after breast conserving surgery.Methods From June 2017 to December 2018,70 patients with early-stage breast cancer(pT1-2N0M0)underwent breast conserving surgery were assigned 1:1 via the random digit number:35 cases hypo-fractionated modulated radiotherapy and 35 cases conventional radiotherapy. The hypo-fractionatedmodulated radiotherapy group received whole breast irradiation 40.5 Gyfor 15 times in 3 weeks with a tumour-bed boost of 48 Gy for 15 times in3 weeks. The conventional radiotherapy group received 25 fractions wholebreast irradiation of 50 Gy in 5 weeks with a tumor-bed boost irradiation of10.0 Gy in one week. The local control rate, cosmetic effect, incidence ofradiation-related side effects and recurrence rate between these two groupswere analyzed. Results There was no recurrence in both of the groups after 1year follow-up. There was no significant difference in cosmetic effect betweenhypo-fractionated modulated radiotherapy group and conventional radiotherapygroup at time point of 1 month and 6 months (P > 0.05, respectively). Nosignificant differences of incidence of acute adverse events ( < grade 2) ,late skin/subcutaneous adverse events and hematotoxic adverse events (suchas neutropenia and thrombocytopenia) were occurred between the hypofractionatedmodulated radiotherapy group and conventional radiotherapygroup (P > 0.05, respectively). But compared to the conventional fractionatedradiotherapy group, and hypo-fractionated modulated radiotherapy grouphad lower treatment costs and shorter hospital stays (P < 0.05). ConclusionEarly-stage breast cancer patients treated with hypo-fractionated modulatedradiotherapy received similar short-term effects with conventional radiotherapy.The shorter treatment procedure and lower treatment costs provide clinicalbenifits for the routine use of hypo-fractionated modulated radiotherapy forearly-stag

关 键 词：早期乳腺癌 保乳手术 大分割调强放疗 瘤床同期推量照射 常规分割调强放疗 临床效益 

分 类 号：R737[医药卫生—肿瘤]