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目的探讨乳腺癌脑转移患者采用全脑放疗与适形调强局部加量放疗联合治疗的临床疗效。方法回顾性分析我院乳腺放疗科2011年1月至2014年6月收治的68例乳腺癌脑转移患者的临床诊治资料,其中34例采用全脑放疗30 Gy后局部缩野照射者为观察组,34例全程局部缩野照射者为对照组,治疗2个周后。比较两组患者的临床疗效、1年生存率、治疗前后生活质量及不良反应。结果观察组病灶临床控制率为55.9%(19/34),明显高于对照组的26.5%(9/34),差异有统计学意义(P<0.05);观察组1年生存者23例(67.6%),明显高于对照组的10例(29.4%),差异有统计学意义(P<0.05);观察组和对照组患者治疗后的KPS评分分别为(89.9±6.3)分、(72.8±5.9)分,均比同组治疗前[(58.9±7.3)分、(59.7±6.9)分]明显提高(P<0.05),且观察组患者治疗后的KPS评分明显高于对照组,差异有统计学意义(P<0.05);观察组食欲下降率明显低于对照组[17.6%(6/34)vs 50.0%(17/34)],差异有统计学意义(P<0.05),但两组患者的恶心呕吐等不良反应率相当。结论应用全脑放疗与适形调强局部加量放疗联合治疗乳腺癌脑转移效果显著,且不良反应较小。
Objective To investigate the clinical efficacy of combined whole-dose radiotherapy and whole-brain radiotherapy in patients with brain metastases of breast cancer. Methods The clinical data of 68 breast cancer patients with brain metastases admitted from January 2011 to June 2014 in our hospital were retrospectively analyzed. Among them, 34 patients underwent whole-brain radiotherapy for 30 days after irradiation were treated with local irradiation , 34 cases of local full-field irradiation for the control group, treatment 2 weeks later. The clinical efficacy, 1-year survival rate, quality of life and adverse reactions before and after treatment were compared between the two groups. Results The clinical control rate of the observation group was 55.9% (19/34), significantly higher than that of the control group (26.5%, 9/34) (P <0.05). The 1-year survival rate in the observation group was 23 67.6%), which was significantly higher than that of the control group (29.4%) (P <0.05). The KPS scores of the observation group and the control group were (89.9 ± 6.3), (72.8 ± 5.9) in the observation group were significantly higher than those in the control group [(58.9 ± 7.3), (59.7 ± 6.9) points] (P <0.05), and the KPS scores in the observation group were significantly higher than those in the control group (P <0.05). The appetite reduction rate in the observation group was significantly lower than that in the control group [17.6% (6/34) vs 50.0% (17/34)], the difference was statistically significant (P <0.05) Two groups of patients with nausea and vomiting and other adverse reactions rate quite. Conclusion The combination of whole-brain radiotherapy with conformal intensity-modulated local dosage and radiotherapy in the treatment of brain metastases of breast cancer has significant effect with small adverse reactions.