摘要
目的对比分析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(简称HF-SIBIMRT)与常规分割放疗的初期临床效果及安全性。方法选取2017年8月—2018年12月合肥市第一人民医院收治的早期浸润性乳腺癌(pT1-2N0M0期)保乳术后的62例患者。采用随机数字表法将其分为HF-SIB-IMRT组(32例)和常规放疗组(30例)。两组均采用全乳腺放疗瘤床同期推量的调强放疗,其中HF-SIB-IMRT组为大分割,PTV (Planning Target Volume) 40.5 Gy/15次,PGTV-tb (Planning Gross Tumor Volumetumor bed) 48 Gy/15次,总疗程为3周;常规放疗组采用常规分割,PTV 50 Gy/25次,PGTV-tb 2.4 Gy/次,总疗程5周。比较两组的局部控制率、复发率、美容效果及放疗不良反应发生率。结果随访1年,两组局部控制率和1年生存率均为100%,均无复发及死亡病例。HF-SIB-IMRT组和常规放疗组放疗结束后1、6个月美容效果优良率,≤2级急性、晚期皮肤不良反应及血液毒性不良反应发生率比较,差异均无统计学意义(P>0.05),而HF-SIB-IMRT组的住院时间及治疗费用均明显低于常规放疗组,差异有统计学意义(P<0.05)。结论对早期乳腺癌患者保乳术后行全乳腺放疗瘤床同期推量的大分割调强放疗,可获得较满意的近期疗效,不增加放疗毒副反应,且具有缩短术后辅助放疗住院总时间和减少治疗费用等临床优势。
Objective To compare the clinical efficacy and safety of hypo-fractionated-simultaneous integrated boost-intensity modulated radiotherapy(HF-SIB-IMRT) and conventional segmentation radiotherapy for early-stage breast cancer patients after breast conserving surgery.Methods From August2017 to December 2018,62 cases of patients with early-stage breast cancer(pT1-2N0 M0 staging) underwent breast conserving surgery in the First People’s Hospital of Zunyi were enrolled and were divided into HF-SIB-IMRT group(32 cases) and conventional radiotherapy group(30 cases) according to the random number table method.The two groups all received intensity modulated radiation therapy for whole breast radiotherapy after breast conserving surgery.The HF-SIB-IMRT group received HFSIB-IMRT,planning target volume(PTV) 40.5 Gy/fifteen times,planning gross tumor volume-tumor bed(PGTV-tb) 48 Gy/fifteen times,the total treatment course was 3 weeks.The routine radiotherapy group received conventional segmentation,PTV 50 Gy/25 times,PGTV-tb 2.4 Gy/one time,the total course of treatment was 5 weeks.The local control rate,recurrence rate,cosmetic effect and incidence of radiation-related side effects were compared between the two groups.Results Both groups were followed up for at least 1 year.The local control rate and the one-year survival rate was all 100% in the two groups.During the follow-up period, there was no recurrence and death patients in both groups.There were no significant difference in cosmetic effect excellence rate on the first month and the sixth month after radiotherapy,the incidence of acute adverse events(<grade 2),late skin/subcutaneous adverse events rate,hematotoxic adverse events rate between HF-SIB-IMRT group and conventional radiotherapy group(all P>0.05).The hospital stay time and treatment costs in HFSIB-IMRT group were significantly lower than those in conventional radiotherapy group(P<0.05).Conclusion HF-SIB-IMRT after breast conserving surgery for early breast cancer patients can obtain satisfactory short-term curative effect,without increasing the toxicity and side effects of radiotherapy,and it also can shorten the total course of radiotherapy after breast conserving surgery and treatment costs.
作者
罗德红
张琴
万林
曹梦璐
陈车
陈睿
陆治江
金天淑
李顺维
刘伟
王慧静
刘道生
LUO De-hong;ZHANG Qin;WAN Lin;CAO Meng-lu;CHEN Che;CHEN Rui;LU Zhi-jiang;JIN Tian-shu;LI Shun-wei;LIU Wei;WANG Hui-jing;LIU Dao-sheng(The Third Affiliated Hospital of Zunyi Medical University/First People's Hospital of Zunyi,Zunyi,Guizhou 563000,China)
出处
《慢性病学杂志》
2020年第7期986-989,993,共5页
Chronic Pathematology Journal
关键词
乳腺癌
保乳手术
瘤床同期推量照射
大分割
临床效益
Breast cancer
Breast conserving surgery
Hypo-fractionated-simultaneous integrated boostintensity modulated radiotherapy
Large division
Clinical benefits
