中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2012年
3期
241-246
,共6页
张烨%惠周光%张江鹄%余子豪%刘新帆%金晶%王维虎%王淑莲%宋永文%刘跃平%任骅%房辉%李晔雄
張燁%惠週光%張江鵠%餘子豪%劉新帆%金晶%王維虎%王淑蓮%宋永文%劉躍平%任驊%房輝%李曄雄
장엽%혜주광%장강곡%여자호%류신범%금정%왕유호%왕숙련%송영문%류약평%임화%방휘%리엽웅
调查%中国大陆地区%乳腺肿瘤/术后放射疗法%乳房切除术,区段
調查%中國大陸地區%乳腺腫瘤/術後放射療法%乳房切除術,區段
조사%중국대륙지구%유선종류/술후방사요법%유방절제술,구단
Surveys%Mainland China%Breast neoplasms/postoperative radiotherapy%Mastectomy,segmental
目的 通过调查全面了解中国大陆地区目前保乳术后放疗应用现状,进一步规范保乳术后放疗的临床实践.方法 2010年3月和8月分两轮向中国大陆地区开展放疗的医院邮寄乳腺癌保乳术后放疗调查表,内容包括2009年度内医院基本信息、保乳综合治疗的一般情况、放疗靶区、适应证和技术细节等.调查内容通过电话或邮件确认.结果 952家医院接受调查,有回复的396家(41.6％),其中328家开展了保乳术后放疗(82.8％).手术至放疗中位间隔时间9周.320家(97.6％)照射患侧乳腺,275家(83.8％)照射锁骨上下区,140家(42.7％)照射腋窝,86家(26.2％)照射内乳区.对原发肿瘤位于乳腺者,把患侧乳腺作为放疗指征的医院占 97.5％ (311/319)；对腋窝淋巴结阳性和淋巴结阳性≥4个者,把锁骨上下区作为照射指征的医院分别占41.8％ (114/273)和31.5％ (86/273),把腋窝作为照射指征的医院比例分别占26.8％ (37/138)和29.0％ (40/138)；对肿瘤位于内象限或中央区者,把内乳区作为照射指征的医院占72.9％( 62/85).所用放疗技术均为常规分割,51.8％医院还开展了三维适形放疗技术,所有靶区中位处方剂量均为50 Gy.结论 中国大陆地区保乳术后放疗目前较为规范,但仍需通过建立和推广保乳术后放疗指南进一步完善.
目的 通過調查全麵瞭解中國大陸地區目前保乳術後放療應用現狀,進一步規範保乳術後放療的臨床實踐.方法 2010年3月和8月分兩輪嚮中國大陸地區開展放療的醫院郵寄乳腺癌保乳術後放療調查錶,內容包括2009年度內醫院基本信息、保乳綜閤治療的一般情況、放療靶區、適應證和技術細節等.調查內容通過電話或郵件確認.結果 952傢醫院接受調查,有迴複的396傢(41.6％),其中328傢開展瞭保乳術後放療(82.8％).手術至放療中位間隔時間9週.320傢(97.6％)照射患側乳腺,275傢(83.8％)照射鎖骨上下區,140傢(42.7％)照射腋窩,86傢(26.2％)照射內乳區.對原髮腫瘤位于乳腺者,把患側乳腺作為放療指徵的醫院佔 97.5％ (311/319)；對腋窩淋巴結暘性和淋巴結暘性≥4箇者,把鎖骨上下區作為照射指徵的醫院分彆佔41.8％ (114/273)和31.5％ (86/273),把腋窩作為照射指徵的醫院比例分彆佔26.8％ (37/138)和29.0％ (40/138)；對腫瘤位于內象限或中央區者,把內乳區作為照射指徵的醫院佔72.9％( 62/85).所用放療技術均為常規分割,51.8％醫院還開展瞭三維適形放療技術,所有靶區中位處方劑量均為50 Gy.結論 中國大陸地區保乳術後放療目前較為規範,但仍需通過建立和推廣保乳術後放療指南進一步完善.
목적 통과조사전면료해중국대륙지구목전보유술후방료응용현상,진일보규범보유술후방료적림상실천.방법 2010년3월화8월분량륜향중국대륙지구개전방료적의원유기유선암보유술후방료조사표,내용포괄2009년도내의원기본신식、보유종합치료적일반정황、방료파구、괄응증화기술세절등.조사내용통과전화혹유건학인.결과 952가의원접수조사,유회복적396가(41.6％),기중328가개전료보유술후방료(82.8％).수술지방료중위간격시간9주.320가(97.6％)조사환측유선,275가(83.8％)조사쇄골상하구,140가(42.7％)조사액와,86가(26.2％)조사내유구.대원발종류위우유선자,파환측유선작위방료지정적의원점 97.5％ (311/319)；대액와림파결양성화림파결양성≥4개자,파쇄골상하구작위조사지정적의원분별점41.8％ (114/273)화31.5％ (86/273),파액와작위조사지정적의원비례분별점26.8％ (37/138)화29.0％ (40/138)；대종류위우내상한혹중앙구자,파내유구작위조사지정적의원점72.9％( 62/85).소용방료기술균위상규분할,51.8％의원환개전료삼유괄형방료기술,소유파구중위처방제량균위50 Gy.결론 중국대륙지구보유술후방료목전교위규범,단잉수통과건립화추엄보유술후방료지남진일보완선.
Objective To evaluate the current practice of breast-conserving radiotherapy (BCR) in mainland China.Methods A questionnaire on the details of treatment pattern of BCR for early breast cancer was mailed twice to all radiotherapy centers in mainland China in 2009.The responding data were collected and analyzed.Results Of the 952 surveyed centers,396 responded (41.6％) and 328 performed BCR.The median interval between surgery and radiotherapy was 9 weeks.Of the 328 centers with BCR,whole breast was the most common irradiation target (319 centers,97.3％ ),followed by supraclavicular region (273 centers,83.2％ ),axilla (138 centers,43.3％ ),and internal mammary chain (85 centers,26.8％ ).In 97.5％ of centers (310/319),whole breast was irradiated in all candidates.Supraclavicular region and axilla irradiation was performed for lymph-node positive patients in 41.8％ (114/273) and 26.8％(37/138) centers,and for ≥4 positive lymph-nodes in 31.5％ (86/273) and 29.0％ (/138)centers,respectively. Internal mammary chain was irradiated for tumors located in the center or inner quadrant in 72.9％ ( 56/85 ) centers.Conformal radiotherapy for the whole breast was used in 51.8％centers.The median total dose was 50 Gy,all using conventional fractionations.Conclusions A consensus has been reached that radiotherapy is needed for patients receiving breast-conserving surgery and that irradiation to whole breast is necessary.However,establishment and widespread use of guidelines for BCR should be strengthened.
