大分割放射治疗不同瘤床补量技术对乳腺癌保乳术后放射性损伤的评价研究  

Study on the evaluation of different replenishment techniques of radiotherapy with large segmentation on tumor bed for radiation injury after breast-conserving surgery for breast cancer

作　　者：王建廷[1] 邵瑞雨 王晶[1] 李娜 熊伟[1] 王晓红[1] WANG Jian-ting;SHAO Rui-yu;WANG Jing(The Sixth Department of Chemo-Radiotherapy,Tangshan People’s Hospital,Tangshan 063001,China;不详)

机构地区：[1]唐山市人民医院放化六科,河北唐山063001

出　　处：《中国医学装备》2023年第7期22-26,共5页China Medical Equipment

基　　金：河北省卫生健康委科研基金(20211663)“乳腺癌保乳术后大分割放疗放射性皮肤损伤的预测分析”。

摘　　要：目的:对比分析乳腺癌保乳术后患者大分割放射治疗中瘤床同步补量与序贯瘤床补量两种技术发生急性和(或)晚期乳房相关放射性损伤、美容效果及近期疗效的差异性,以提高乳腺癌保乳术后大分割放射治疗的安全性和有效性。方法:选取在医院行乳腺癌保乳术后大分割放射治疗的109例女性患者,根据瘤床补量技术的不同,将其分为观察组(56例)和对照组(53例),观察组行瘤床同步补量调强放射治疗(SIB-IMRT),对照组行全乳调强放射治疗(IMRT)后序贯瘤床电子线补量放射治疗。对两组患者急性放射性皮肤损伤、放射治疗结束2年后皮肤及皮下组织放射性损伤、放射治疗结束1个月和2年后美容效果以及近期疗效分别进行比较。结果:放射治疗后109例患者急性放射性皮肤损伤主要为≤1级(占91.7%),放射治疗结束2年后皮肤及皮下组织放射性损伤主要为≤1级(占86.2%),放射治疗结束1个月和2年后美容效果优良率分别为87.2%(95/109)和90.8%(99/109),2年局部肿瘤控制率、无疾病生存率均为100%。两组患者在放射治疗结束2年后出现皮肤及皮下组织放射性损伤、放射治疗结束1个月和2年后美容效果及近期疗效均无统计学差异。观察组患者≥2级急性放射性皮肤损伤发生率为1.8%(1/56),明显低于对照组[15.1%(8/53)],差异有统计学意义(x^(2)=6.367,P<0.05)。结论:乳腺癌保乳术后大分割放射治疗的安全性和疗效较好,应用瘤床同步补量技术更能够降低2级以上急性放射性皮肤损伤的发生率,可优先选择该方式治疗。Objective:To compare and analyze the differences of occurring acutely and/or lately related breast radiation injuries,cosmetic effects and short-term effects between simultaneous replenishment for tumor bed and sequential replenishment for tumor bed in radiotherapy with large segmentation of patients after breast-conserving surgery for breast cancer,so as to improve the safety and effectiveness of radiotherapy with large segmentation after breast conserving surgery for breast cancer.Methods:A total of 109 patients with breast cancer who received radiotherapy with large segmentation after breast-conserving surgery in hospital were selected and they were divided into observation group(56 cases)and control group(53 cases)according to different replenishment techniques for tumor bed.The observation group was treated with simultaneous integrated boost intensity-modulated radiotherapy(SIB-IMRT).The control group received intensity-modulated radiotherapy(IMRT)on whole breast followed by radiotherapy with sequential electron beam replenishment for tumor bed.The acute radiation-induced skin injury,radiation-induced skin and subcutaneous tissue injury at the 2nd year after completing radiotherapy,the cosmetic effect at the 1st month and the 2nd year after completing radiotherapy,and the short-term effect were compared between the two groups.Results:After radiotherapy,the acute radiation-induced skin injury of 109 patients mainly was≤grade 1(91.7%).At the 2nd year after completed radiotherapy,the radiation-induced skin and subcutaneous tissue injury of 109 patients was mainly≤grade 1(86.2%).The excellent and good rates of cosmetic effects at the 1st month and the 2nd year after completed radiotherapy respectively were 87.2%(95/109)and 90.8%(99/109).Both of the controlled rate of 2-year local tumor and diseasefree survival rate were 100%.There were no statistically significant differences between the two groups in the radiationinduced skin and subcutaneous tissue injury at the 2nd year after completed radiotherapy,the co

关 键 词：乳腺癌 保乳术 大分割放射治疗 瘤床补量 技术评价 

分 类 号：R818.74[医药卫生—放射医学]