CAJ | 학술논문

目的探讨乳腺癌术后辅助内分泌治疗和放疗(同步或序贯)对放射性肺损伤发生的影响.方法收集于2003年1月至2007年12月间行乳腺癌根治(或改良根治)术后辅助放疗和内分泌治疗的患者,根据入组条件筛选出118例患者,分为4组,放疗(RT)同步芳香化酶抑制剂(AI)组(RT+AI),放疗同步他莫昔芬(TAM)组(RT+TAM),放疗序贯AI组(RT-AI),放疗序贯TAM组(RT-TAM).通过网络影像系统查阅其放疗后1个月和至少12个月间的胸部CT影像资料.结果放射性肺损伤发生率:RT+AI组(22.7%)和RT-AI组(20.0%)差异无统计学意义(P=0.806),RT+TAM组(35.7%)和RT-TAM组(24.2%)差异无统计学意义(P=0.328).高龄患者发生率高于低龄患者(33.9%,16.9%)(P=0.05).术后有化疗史的患者高于无化疗史的患者(P=0.039).结论乳腺癌术后辅助化疗以及老年患者存在肺内基础疾病会增加术后放疗放射性肺损伤的发生;放射性肺损伤的发生与是否同步应用TAM或AI内分泌治疗无关.
목적 탐토유선암술후보조내분비치료화방료(동보혹서관)대방사성폐손상발생적영향.방법 수집우2003년1월지2007년12월간행유선암근치(혹개량근치)술후보조방료화내분비치료적환자,근거입조조건사선출118례환자,분위4조,방료(RT)동보방향화매억제제(AI)조(RT+AI),방료동보타막석분(TAM)조(RT+TAM),방료서관AI조(RT-AI),방료서관TAM조(RT-TAM).통과망락영상계통사열기방료후1개월화지소12개월간적흉부CT영상자료.결과 방사성폐손상발생솔:RT+AI조(22.7%)화RT-AI조(20.0%)차이무통계학의의(P=0.806),RT+TAM조(35.7%)화RT-TAM조(24.2%)차이무통계학의의(P=0.328).고령환자발생솔고우저령환자(33.9%,16.9%)(P=0.05).술후유화료사적환자고우무화료사적환자(P=0.039).결론 유선암술후보조화료이급노년환자존재폐내기출질병회증가술후방료방사성폐손상적발생;방사성폐손상적발생여시부동보응용TAM혹AI내분비치료무관.
Objective To compare radiation-induced lung injury (RILI) between concurrent and sequential combination of postoperative radiotherapy and endocrine therapy. Methods A total of 118 patients subjected by radical or modified radical operation of breast cancer were enrolled in this study and received radiotherapy and endocrine therapy between Jan 2003 and December 2007. All the patients were categorized into four groups: radiotherapy (RT) plus concurrent aromatase inhibitor(AI): RT+AI; RT plus sequential AI:RT-AI; RT plus tamoxifen (TAM): RT+TAM; RT plus sequential TAM: RT-TAM. Radiotherapy was delivered by using various energy of electron (6, 9, 12 Mev β-ray) or 6 M.V X-ray for different target with a dose of 50 Gy (2 Gy/Fx, 5 fractions per week). RILI grades were classified according to RTOG/EORTC and Aoki evaluation criteria from one month to at least one year after radiotherapy. Results 30/118(25.4 %) patients was observed with RILI, RT+AI 22.7 % vs. RT-AI 20.0 %(P =0.806), RT+TAM 35.7 % vs. RT-TAM 24.2 %(P =0.328). The incident rate of RILI was higher in elder patients(>60 yr) than in other patients (33.9 % vs.16.9 %, P =0.05). Patients with positive chemotherapy history had a higher risk of RILI than those with chemotherapy-negtive history (P =0.039). Conclusion These findings suggest that RILI are associated with age and chemotherapy history, but not correlated with the sequence of radiotherapy and endocrine therapy.