乳腺癌全乳大分割放疗同步瘤床加量对免疫功能的影响  

Effect of hypofractionated simultaneous integrated boost radiotherapy on immune function in patients with breast cancer

作　　者：周洋 刘晶晶 王晓红[2] 李娜 李彬 李玉凤[1] Zhou Yang;Liu Jingjing;Wang Xiaohong;Li Na;Li Bin;Li Yufeng(Hebei Key Laboratory of Molecular Oncology,The Cancer Institute,Tangshan People's Hospital,Tangshan 063001,China;The Sixth Department of Chemoradiotherapy,Tangshan People's Hospital,Tangshan 063001,China)

机构地区：[1]河北省分子肿瘤学重点实验室,唐山市人民医院中心实验室,唐山063001 [2]唐山市人民医院放化六科,唐山063001

出　　处：《中华放射肿瘤学杂志》2024年第7期627-633,共7页Chinese Journal of Radiation Oncology

基　　金：唐山市科技计划项目(23150213A);河北省医学适用技术跟踪项目(GZ2023017)。

摘　　要：目的探索乳腺癌保乳术后大分割调强放疗同步瘤床加量对比序贯瘤床加量对患者免疫功能的影响。方法回顾性分析2021年1月—2023年4月唐山市人民医院收治的乳腺癌保乳术后200例患者的资料。根据瘤床加量方式分为同步加量组、序贯加量组(对照),各100例。两组患者均接受大分割调强放疗,全乳剂量均为43.5 Gy分15次。同步加量组和序贯加量组的瘤床加量剂量分别为49.5 Gy分15次、8.7 Gy分3次。采用t检验比较两组患者外周血淋巴细胞计数(PLC)和T淋巴细胞亚群变化情况的差异。结果放疗前,两组患者基线PLC及CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞计数和CD4^(+)/CD8^(+)差异无统计学意义(均为P>0.05)。放疗后,两组患者均出现PLC及CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞计数减少,但CD4^(+)/CD8^(+)无改变。放疗后同步加量组和序贯加量组患者的PLC[(1.01±0.29)×10^(9)/L∶(1.08±0.40)×10^(9)/L],以及CD3^(+)T细胞[(557.77±152.29)∶(555.17±162.31)个/μl]、CD4^(+)T细胞[(312.29±120.78)∶(295.17±106.81)个/μl]、CD8^(+)T细胞[(211.77±62.88)∶(223.94±1.69)个/μl]计数、CD4^(+)/CD8^(+)(1.54±0.46∶1.39±0.52)差异无统计学意义(均为P>0.05)。结论乳腺癌保乳术后大分割放疗同步瘤床加量与序贯瘤床加量相比,两者对患者淋巴细胞计数和T淋巴细胞亚群的影响无差异。Objective To evaluate the effect of simultaneous integrated boost verse sequential boost in hypofractionated radiotherapy on immune function in patients with breast cancer after breast-conserving surgery.Methods Clinical data of 200 patients with breast cancer undergoing breast-conserving surgery in Tangshan People's Hospital from January 2021 to April 2023 were retrospectively analyzed.All patients were divided into the simultaneous integrated boost group and sequential boost group(control)with 100 patients in each group according to the dosage method of the tumor bed.Both groups of patients received hypofractionated radiotherapy with the whole breast radiation dose of 43.5 Gy in 15 fractions.The tumor bed dose for the simultaneous integrated boost group and sequential boost group were 49.5 Gy in 15 fractions and 8.7 Gy in 3 fractions,respectively.Changes in peripheral lymphocyte counts(PLC)and T lymphocyte subsets before and after radiotherapy were compared between two groups using t-test.Results Before radiotherapy,the baseline PLC,CD3^(+)T lymphocytes,CD4^(+)T lymphocytes,CD8^(+)T lymphocytes and CD4^(+)/CD8^(+)were comparable between two groups(all P>0.05).After radiotherapy,the PLC,CD3^(+)T lymphocytes,CD4^(+)T lymphocytes and CD8^(+)T lymphocytes were decreased in both groups,but CD4^(+)/CD8^(+)did not change.There were no statistical significances in PLC[(1.01±0.29)×10^(9)/L vs.(1.08±0.40)×10^(9)/L],CD3^(+)T lymphocytes[(557.77±152.29)vs.(555.17±162.31)/μl],CD4^(+)T lymphocytes[(312.29±120.78)vs.(295.17±106.81)/μl],CD8^(+)T lymphocytes[(211.77±62.88)vs.(223.94±1.69)/μl]and CD4^(+)/CD8^(+)(1.54±0.46 vs.1.39±0.52)between two groups(all P>0.05).Conclusion There is no difference in PLC and T lymphocyte subsets between the simultaneous integrated boost and sequential boost in hypofractionated radiotherapy for patients after breast-conserving surgery.

关 键 词：乳腺肿瘤 放射疗法 大分割调强 同步瘤床加量 序贯瘤床加量 免疫功能 

分 类 号：R737.9[医药卫生—肿瘤]