大分割调强放疗与二维放疗在乳腺癌保乳术后患者中的应用效果比较  

Comparison of application effects of hypofractionated intensity-modulated radiotherapy and two-dimensional radiotherapy in patients with breast cancer after breast-conserving surgery

作　　者：薛晔 XUE Ye(Department of Radiation Physics Technology of Dezhou Second People’s Hospital,Dezhou 253011 Shandong,China)

机构地区：[1]德州市第二人民医院放射物理技术科,山东德州253011

出　　处：《中国民康医学》2025年第4期154-157,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较大分割调强放疗与二维放疗在乳腺癌保乳术后患者中的应用效果。方法:回顾性分析2022年7月至2023年11月该院收治的90例乳腺癌保乳术后患者的临床资料,根据放疗方案不同将其分为对照组(n=45)与观察组(n=45)。对照组采用二维放疗,观察组采用大分割调强放疗,比较两组治疗前后肿瘤标志物[癌胚抗原(CEA)、糖链抗原19-9(CA19-9)、糖类抗原15-3(CA15-3)]水平、T细胞亚群指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平、疾病相关指标[血管内皮生长因子(VEGF)、单核细胞趋化蛋白-1(MCP-1)、C-C趋化因子配体20(CCL20)]水平,放射损伤发生率和局部复发率。结果:治疗后,两组CEA、CA15-3、CA19-9水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均低于治疗前,但观察组高于对照组,两组CD8^(+)水平均高于治疗前,但观察组低于对照组,差异有统计学意义(P<0.05);两组VEGF、MCP-1、CCL20水平均低于治疗前,且观察组低于治疗前,差异有统计学意义(P<0.05);观察组放射损伤发生率低于对照组,差异有统计学意义(P<0.05);两组局部复发率比较,差异无统计学意义(P>0.05)。结论:大分割调强放疗应用于乳腺癌保乳术后患者可降低肿瘤标志物水平、疾病相关指标水平和放射损伤发生率,以及改善T细胞亚群指标水平的效果优于二维放疗。Objective:To compare application effects of hypofractionated intensity modulated radiotherapy and two-dimensional radiotherapy in patients with breast cancer after breast-conserving surgery.Methods:The clinical data of 90 patients with breast cancer after breastconserving surgery in this hospital from July 2022 to November 2023 were retrospectively analyzed.According to different radiotherapy regimens,they were divided into control group(n=45)and observation group(n=45).The control group was treated with two-dimensional radiotherapy,while the observation group was treated with hypofractionated intensity-modulated radiotherapy.The levels of tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 15-3(CA15-3)],T cell subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and diseaserelated indexes[vascular endothelial growth factor(VEGF),monocyte chemoattractant protein-1(MCP-1),C-C motif chemokine ligand 20(CCL20)]before and after the treatment,the incidence of radiation injury,and the local recurrence rate were compared between the two groups.Results:After the treatment,the levels of CEA,CA15-3 and CA19-9 in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were lower than those before the treatment,but those in the observation group were higher than those in the control group;the levels of CD8^(+)in the two groups were higher than those before the treatment,but that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).After the treatment,the levels of VEGF,MCP-1 and CCL20 in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of radi

关 键 词：乳腺癌 保乳术 大分割调强放疗 二维放疗 肿瘤标志物 T细胞亚群 放射损伤 

分 类 号：R737.9[医药卫生—肿瘤]