| 早期乳腺癌保乳术后全乳大分割照射同步瘤床加量与常规分割放疗的效果对比 |
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| 引用本文： | 王升晔,杜向慧,封巍,白雪,陈建祥,郑远达,季文豪,孔月,莫文菊,楼建林.早期乳腺癌保乳术后全乳大分割照射同步瘤床加量与常规分割放疗的效果对比[J].中华全科医学,2019,17(8):1292-1295. |
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| 作者姓名： | 王升晔 杜向慧 封巍 白雪 陈建祥 郑远达 季文豪 孔月 莫文菊 楼建林 |
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| 作者单位： | 浙江省肿瘤医院放疗科, 浙江 杭州 310022 |
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| 基金项目： | 浙江省科技厅公益项目(2015C33190)；浙江省医药卫生学科平台项目(2018ZD014)；浙江省中医药科技计划青年人才基金项目(2015ZQ010)；浙江省肿瘤医院“1022”人才培养计划 |
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| 摘 要： | 目的比较对早期乳腺癌患者保留乳房手术后行全乳大分割照射并瘤床区同步加量调强放疗(简称HF-SIB-IMRT)与常规分割放疗方案的临床效果及安全性。方法 2015年8月-2017年8月在浙江省肿瘤医院共纳入60例早期浸润性导管乳腺腺癌(T1~T2N0M0期)行保乳术患者。根据随机数字表法将其分为HF-SIB-IMRT组(30例)和常规放疗组(30例)。术后放疗方案:HF-SIB-IMRT组为全乳腺照射同步行瘤床区推量照射,总疗程24 d。常规放疗组为全乳腺照射后序贯瘤床区局部加量照射,总疗程44 d。比较2组的局部控制率,美容效果,放疗相关毒副反应发生率及复发率。结果随访1.5年,2组均无复发及死亡病例,局部控制率和1年生存率均为100%。HF-SIB-IMRT组和常规放疗组放疗结束后1个月、6个月美容效果优良率比较差异均无统计学意义(均P>0.05);2组≤2级急性不良反应、晚期皮肤/皮下组织的不良反应,中性粒细胞、血小板减少等血液毒性不良反应发生率比较,差异均无统计学意义(均P>0.05)。结论对早期乳腺癌患者保乳术后行全乳大分割照射并瘤床区同步加量放疗,可获得较为满意的近期疗效,并不增加放疗毒副反应,可缩短术后放疗总疗程时间是其临床优势。
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| 关 键 词： | 早期乳腺癌 保留乳房手术 全乳照射 大分割 瘤床区同步推量照射 临床效益 |
| 收稿时间： | 2019-03-01 |
Comparison of the effect be hypofractionated -simultaneous integrated boost-intensity modulated radiotherapy and conventional radiotherapy in early-stage breast cancer after breast conserving surgery |
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| Affiliation: | Department of Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, China |
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| Abstract: | Objective To compare the clinical efficacy and safety of hypofractionated -simultaneous integrated boost-intensity modulated radiotherapy (HF-SIB-IMRT) and conventional radiotherapy for early-stage breast cancer patients after breast-conserving surgery. Methods From August 2015 to August 2017, 60 patients with early-stage invasive ductal breast cancer (cT1-T2N0M0 staging) underwent breast conserving surgery in a hospital were enrolled. According to the random number table method, they were divided into HF-SIB-IMRT group (30 cases) and conventional radiotherapy group (30 cases). After operation, the HF-SIB-IMRT group received total breast irradiation for 15 times, and simultaneous integrated boost of tumor bed for 24 days. The routine radiotherapy group received 25 fractions of total breast irradiation followed by sequential irradiation, and local total irradiation 60.0 Gy in the tumor bed. The total course of treatment was 44 days. The local control rate, cosmetic effect, incidence of radiation-related side effects and recurrence rate were compared between the two groups. Results Both groups were followed up for at least 1.5 years. During the follow-up period, there was no recurrence in both groups. The local control rate was 100% and the one-year survival rate was 100%. There was no significant difference in cosmetic effect between HF-SIB-IMRT group and conventional radiotherapy group at the end of 1 month,6 months (all P>0.05). There was no significant difference between HF-SIB-IMRT group and routine radiotherapy group in the incidence of acute adverse events (0.05). Conclusion Whole breast hypofractionated intensity modulated radiotherapy with simultaneous integrated boost of tumor bed 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 can shorten the total course of radiotherapy after breast conserving surgery, which is its clinical advantage. |
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| Keywords: | Early breast cancer Breast conserving surgery Whole breast irradiation Hypofraction Simultaneous integrated boost in tumor bed area Clinical benefits |
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