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
4期
352-356
,共5页
惠周光%张烨%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
惠週光%張燁%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
혜주광%장엽%장강곡%여자호%류신범%금정%왕유호%왕숙련%송영문%류약평%임화%방휘%리엽웅
第二次调查%中国大陆地区%乳腺肿瘤/术后放射疗法%乳房切除术,改良根治性%第一次调查比较
第二次調查%中國大陸地區%乳腺腫瘤/術後放射療法%乳房切除術,改良根治性%第一次調查比較
제이차조사%중국대륙지구%유선종류/술후방사요법%유방절제술,개량근치성%제일차조사비교
Second time surveys%Mainland China%Breast neoplasms/postoperative radiotherapy%Mastectomy,modified radical%Compare with first time survey
目的 通过对中国大陆地区两次乳腺癌改良根治术后放疗现状调查的比较,评价6年间改善情况.方法 2010年3月和8月分两轮向拥有放疗单位的医院邮寄调查表,内容主要包括医院基本信息、乳腺癌改良根治术后放疗适应证和治疗技术细节等.调查结果与2004年首次调查结果进行比较,并用Fisher's精确概率法检验差异.结果 952家医院中396家(41.6％)开展了改良根治术后放疗,比首次的29.4％(210/715)有所增加.与首次调查相比,手术至放疗中位间隔时间增加6周(12周∶6周),术后最常用放化疗顺序由原来的化放化疗(71.7％)转变为序贯化放疗(73.5％).仅以T3或Ⅲ期和(或)腋窝淋巴结转移≥4个作为术后放疗适应证医院占29.5％,而2004年度时仅为7.1％.术后对T1 -2N0期、T1-2N0期肿瘤位于内象限或中央区、T1～2期且腋窝淋巴结转移1～3个者放疗的医院比例由2004年度的11.9％、63,8％、87.6％下降至1.5％、19.7％、62.1％(p均=0.000).最常见照射靶区仍然为胸壁和锁骨上下区(均为97.0％,2004年度时分别为97.1％和96.2％),内乳区和腋窝分别减少至39.1％和50.0％(2004年度时分别为85.2％、74.8％).胸壁照射时以手术瘢痕作为参考加量占75.0％(2004年度时为9.0％).结论 近年中国大陆地区乳腺癌改良根治术后放疗现状进步较大,对适应证和放疗技术的选择更符合规范,但仍还需进一步完善.
目的 通過對中國大陸地區兩次乳腺癌改良根治術後放療現狀調查的比較,評價6年間改善情況.方法 2010年3月和8月分兩輪嚮擁有放療單位的醫院郵寄調查錶,內容主要包括醫院基本信息、乳腺癌改良根治術後放療適應證和治療技術細節等.調查結果與2004年首次調查結果進行比較,併用Fisher's精確概率法檢驗差異.結果 952傢醫院中396傢(41.6％)開展瞭改良根治術後放療,比首次的29.4％(210/715)有所增加.與首次調查相比,手術至放療中位間隔時間增加6週(12週∶6週),術後最常用放化療順序由原來的化放化療(71.7％)轉變為序貫化放療(73.5％).僅以T3或Ⅲ期和(或)腋窩淋巴結轉移≥4箇作為術後放療適應證醫院佔29.5％,而2004年度時僅為7.1％.術後對T1 -2N0期、T1-2N0期腫瘤位于內象限或中央區、T1～2期且腋窩淋巴結轉移1～3箇者放療的醫院比例由2004年度的11.9％、63,8％、87.6％下降至1.5％、19.7％、62.1％(p均=0.000).最常見照射靶區仍然為胸壁和鎖骨上下區(均為97.0％,2004年度時分彆為97.1％和96.2％),內乳區和腋窩分彆減少至39.1％和50.0％(2004年度時分彆為85.2％、74.8％).胸壁照射時以手術瘢痕作為參攷加量佔75.0％(2004年度時為9.0％).結論 近年中國大陸地區乳腺癌改良根治術後放療現狀進步較大,對適應證和放療技術的選擇更符閤規範,但仍還需進一步完善.
목적 통과대중국대륙지구량차유선암개량근치술후방료현상조사적비교,평개6년간개선정황.방법 2010년3월화8월분량륜향옹유방료단위적의원유기조사표,내용주요포괄의원기본신식、유선암개량근치술후방료괄응증화치료기술세절등.조사결과여2004년수차조사결과진행비교,병용Fisher's정학개솔법검험차이.결과 952가의원중396가(41.6％)개전료개량근치술후방료,비수차적29.4％(210/715)유소증가.여수차조사상비,수술지방료중위간격시간증가6주(12주∶6주),술후최상용방화료순서유원래적화방화료(71.7％)전변위서관화방료(73.5％).부이T3혹Ⅲ기화(혹)액와림파결전이≥4개작위술후방료괄응증의원점29.5％,이2004년도시부위7.1％.술후대T1 -2N0기、T1-2N0기종류위우내상한혹중앙구、T1～2기차액와림파결전이1～3개자방료적의원비례유2004년도적11.9％、63,8％、87.6％하강지1.5％、19.7％、62.1％(p균=0.000).최상견조사파구잉연위흉벽화쇄골상하구(균위97.0％,2004년도시분별위97.1％화96.2％),내유구화액와분별감소지39.1％화50.0％(2004년도시분별위85.2％、74.8％).흉벽조사시이수술반흔작위삼고가량점75.0％(2004년도시위9.0％).결론 근년중국대륙지구유선암개량근치술후방료현상진보교대,대괄응증화방료기술적선택경부합규범,단잉환수진일보완선.
Objective To assess the current practice of postmastectomy radiotherapy (PMRT) in mainland China and to evaluate the improvement in the past six years.Methods A questionnaire on the indications and techniques for PMRT for breast cancer was delivered to all radiotherapy centers of mainland China in 2010 survey,and the results were analyzed and compared with those in 2004 survey.The Fisher's exact test was used.Results Compared to 29.4％ (210/275) in 2004,396 of the 952 (41.6％) surveyed centers had performed PMRT.The median interval between surgery and PMRT was increased from 6 weeks to 12 weeks during the past 6 years.Adjuvant chemotherapy followed by PMRT was the most common combination in 73.5％ of the responding centers in 2010 other than" Sandwich" (71.7％) sequence of chemotherapy and PMRT in 2004.PMRT was only performed for T3 or Stage Ⅲ tumors and/or ≥ 4 positive lymph nodes (LN + ) in 7.1％ centers in 2004 and in 29.5％ centers in 2010 surveys,respectively.The use of PMRT for T1-2 N0 breast cancer,T1-2 N0 with tumors located in the center or inner quadrant,and stage T1-T2 and one to three LN + was decreased from 11.9％,63.8％,and 87.6％ in 2004 to 1.5％,19.7％,and 62.1％ in 2010,respectively (all P =0.000).The chest wall and the supraclavicular region were the most common radiation targets,which were used in 97.0％ and 97.0％ in 2010,similar to 97.1％and 96.2％ in 2004.Irradiation to the inner mammary area and axillary fossa decreased from 85.2％ and 74.8％ in 2004 to 39.1％ and 50.5％ in 2010.The boost to the chest wall was more based on the scar,increasingfrom9.0％ in004to75.0％ in 2010.Conclusions There are a high level of compliance of the practices with current guideline and continuing improvement of PMRT for breast cancer in mainland China.But it needs further improvement.
