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目的探讨早期乳腺癌保乳术后行调强放疗的近期疗效。方法回顾性分析2007年1月-2009年1月收治的55例保乳治疗后行放疗的早期乳腺癌患者的临床资料,其中28例(50.9%)行调强放疗,27例(49.1%)行常规放疗,两组照射剂量均为全乳腺照射50 Gy/25次,瘤床补量10 Gy/5次,观察临床毒性反应、疗效及美容效果。结果调强放疗组中发生1级急性放射性皮肤反应26例,2级2例,而常规放疗组中分别为19例、8例,调强放疗组较常规放疗组,降低了2级急性放射性皮肤反应的发生率(7.1%vs 29.6%,P<0.05),两组均未发现3、4级急性放射性皮肤反应及乳腺纤维化,两组3年局部控制率、无瘤生存率及远处转移率差异均无统计学意义;随访3年,调强放疗组美容评分均在3分以上,优良率100%,常规放疗组中1例患者出现双侧乳腺对称性差,评分2分,其余26例评分在3分以上,两组患者随访至今未发现明显的放射性心脏、肺毒性。结论早期乳腺癌保乳术后调强放疗降低了2级急性皮肤反应发生率,3年随访,肿瘤局部控制率、无瘤生存率及远处转移率与常规放疗组相比差异无统计学意义,乳腺毒副反应轻,美容效果好,提高了患者的生活质量。
Objective To investigate the short-term effect of intensity-modulated radiotherapy after breast-conserving surgery in early breast cancer. Methods The clinical data of 55 patients with early-stage breast cancer who underwent breast-conserving therapy from January 2007 to January 2009 were analyzed retrospectively. Twenty-eight patients (50.9%) underwent intensity-modulated radiotherapy and 27 patients (49.1% Routine radiotherapy was performed. The total radiation dose of both groups was 50 Gy / 25 times of total breast irradiation and the volume of tumor bed was 10 Gy / 5 times. Clinical toxicity, curative effect and cosmetic effect were observed. Results In IMRT group, there were 26 cases of grade 1 acute radiation reaction and 2 cases of grade 2 in radiotherapy group, compared with 19 cases in routine radiotherapy group, 8 cases in intensity-modulated radiotherapy group and 2 cases in acute radiosensitization radiotherapy group (7.1% vs 29.6%, P <0.05). No grade 3 or 4 acute radiation-induced skin reaction or fibrosis was observed in both groups. The three-year local control, tumor-free survival and distant metastasis There was no significant difference in the rates between the two groups. After 3 years of follow-up, the cosmetic scores of IMRT group were all above 3, the excellent and good rate was 100%. In the conventional radiotherapy group, 1 patient had bilateral breast symmetry difference of 2 points and the remaining 26 cases Score at 3 points or more, two groups of patients were followed up so far found no significant radioactive heart, lung toxicity. Conclusions IMRT after grade 2 breast-conserving surgery reduces the incidence of grade 2 acute skin reaction. There is no significant difference in the local control rate, tumor-free survival rate and distant metastasis rate between the two groups at 3-year follow-up , Mild side effects of breast, cosmetic effect is good, improve the quality of life of patients.