大分割放疗治疗早期乳腺癌保乳手术后患者的疗效及安全性

目的分析两种放疗方案治疗早期乳腺癌保乳手术后患者的近期应用效果及安全性。方法将110例行保乳手术的早期乳腺癌患者依据保乳术后采用的放疗方法不同分为观察组(采用大分割放疗,n=55)与对照组(采用常规分割放疗,n=55),治疗后随访2年,比较两组生存情况、危及器官所受剂量、急慢性不良反应发生率、美容效果、治疗次数与治疗费用。结果两组患者近期生存率均达100%。观察组患者危及器官肺、心脏、脊髓、肝脏所受放疗剂量均明显低于对照组(P<0.01)。两组患者急慢性不良反应以Ⅰ级及Ⅱ级为主,且两组急慢性不良反应发生率比较,差异均无统计学意义(P>0.05)。两组患者美容效果比较,差异无统计学意义(P>0.05)。观察组患者治疗次数、治疗费用均少于对照组(P<0.01)。结论与常规分割放疗方案相比,大分割放疗有助于提高早期乳腺癌保乳术后患者疗效,有更好的社会经济学效益,且能减少危及器官受量,安全性可靠,美容效果相当。

Effect and safety of hypofractionated radiotherapy for early breast cancer patients after breast-conserving surgery

Objective To investigate the short-term effect and safety of two radiotherapy schemes for early breast cancer patients after breast-conserving surgery(BCS).Method The clinical data of 110 patients with early breast cancer who underwent BCS were retrospectively analyzed.According to different radiotherapy schemes administered after BCS,these patients were divided into study group(with hypofractionated radiotherapy,n=55)and control group(conventionally fractionated radiotherapy,n=55),and all patients were followed up for 2 years after treatment.The survival rate,dosesin organs at risk(OAR),incidence of acute and chronic adverse reactions,cosmetic effect,frequency of treatment and treatment costs were compared between the two groups.Result Both groups of patients had achieved 100%short-term survival rate.The dose sin OAR,such as lung,heart,spinal cord and liver in study group were significantly lower than that in control group(P<0.01).The acute and chronic adverse reactions in both groups were mainly gradeⅠorⅡ,besides there was no significant difference in regard to the incidences of acute and chronic adverse reactions between the two groups(P>0.05).Similar cosmetic effects were noted in the two groups(P>0.05).The frequency of treatment and treatment cost of study group were less compared to control group(P<0.01).Conclusion Compared with conventionally fractionated radiotherapy scheme,hypofractionated radiotherapy helps improve the curative effect for early breast cancer patients undergoing BCS,which is accompanied with better socioeconomic benefits,with reduced dose in OAR,demonstrating its safety,furthermore,the cosmetic effect is uncompromised.