中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2010年
5期
434-436
,共3页
司马义力·买买提尼牙孜%木克代斯·拜克提亚尔%贺春钰%艾秀清%朱相露%成芳%许素玲%张新春%木妮热·木沙江
司馬義力·買買提尼牙孜%木剋代斯·拜剋提亞爾%賀春鈺%艾秀清%硃相露%成芳%許素玲%張新春%木妮熱·木沙江
사마의력·매매제니아자%목극대사·배극제아이%하춘옥%애수청%주상로%성방%허소령%장신춘%목니열·목사강
乳腺肿瘤/放射疗法%放射疗法,保乳术后%放射疗法,调强%预后
乳腺腫瘤/放射療法%放射療法,保乳術後%放射療法,調彊%預後
유선종류/방사요법%방사요법,보유술후%방사요법,조강%예후
Breast neoplasms/radiotherapy%Radiotherapy,breast-conserving surgery%Radiotherapy,intensity modulated%Prognosis
目的 观察乳腺癌保乳术+化疗后动态调强放疗的疗效和美容效果.方法 117例乳腺癌患者保乳术后先行4~6周期化疗再三维适形(6例)和动态调强放疗(111例).化疗分别采用CAF(环磷酰胺+多柔比星+氟尿嘧啶)、AC(多柔比星+环磷酰胺)、TA(紫杉醇+多柔比星)、NE(长春瑞滨+表阿霉素)、TX(紫杉醇+卡培他滨)方案.放疗采用6 MV-X线全乳腺调强放疗50Gy,瘤床电子线外照射加量10 Gy;其中68例患者锁骨上预防性照射50 Gy,42例肿块位于内侧象限的同时照射内乳淋巴引流区,锁骨上区、内乳区及胸壁均包在一个靶区里.雌、孕激素受体阳性加用内分泌治疗.治疗结束后6~12个月由2位医师评分评价美容效果.结果 随访至2009年9月,随访率为94.0%,随访满3、5年者分别为114、91例.全组3生存率为99.1%,5年生存率为96%,5年无瘤生存率为88%,局部复发率为3.6%,美容效果满意者为100%.放疗中及放疗结束后未出现明显放射性心肺等重要脏器损伤.结论 乳腺保乳术+化疗后胸壁动态调强放疗使靶区得到更均匀照射,有望提高局部控制率和生存率并降低正常组织并发症、肿瘤复发率.
目的 觀察乳腺癌保乳術+化療後動態調彊放療的療效和美容效果.方法 117例乳腺癌患者保乳術後先行4~6週期化療再三維適形(6例)和動態調彊放療(111例).化療分彆採用CAF(環燐酰胺+多柔比星+氟尿嘧啶)、AC(多柔比星+環燐酰胺)、TA(紫杉醇+多柔比星)、NE(長春瑞濱+錶阿黴素)、TX(紫杉醇+卡培他濱)方案.放療採用6 MV-X線全乳腺調彊放療50Gy,瘤床電子線外照射加量10 Gy;其中68例患者鎖骨上預防性照射50 Gy,42例腫塊位于內側象限的同時照射內乳淋巴引流區,鎖骨上區、內乳區及胸壁均包在一箇靶區裏.雌、孕激素受體暘性加用內分泌治療.治療結束後6~12箇月由2位醫師評分評價美容效果.結果 隨訪至2009年9月,隨訪率為94.0%,隨訪滿3、5年者分彆為114、91例.全組3生存率為99.1%,5年生存率為96%,5年無瘤生存率為88%,跼部複髮率為3.6%,美容效果滿意者為100%.放療中及放療結束後未齣現明顯放射性心肺等重要髒器損傷.結論 乳腺保乳術+化療後胸壁動態調彊放療使靶區得到更均勻照射,有望提高跼部控製率和生存率併降低正常組織併髮癥、腫瘤複髮率.
목적 관찰유선암보유술+화료후동태조강방료적료효화미용효과.방법 117례유선암환자보유술후선행4~6주기화료재삼유괄형(6례)화동태조강방료(111례).화료분별채용CAF(배린선알+다유비성+불뇨밀정)、AC(다유비성+배린선알)、TA(자삼순+다유비성)、NE(장춘서빈+표아매소)、TX(자삼순+잡배타빈)방안.방료채용6 MV-X선전유선조강방료50Gy,류상전자선외조사가량10 Gy;기중68례환자쇄골상예방성조사50 Gy,42례종괴위우내측상한적동시조사내유림파인류구,쇄골상구、내유구급흉벽균포재일개파구리.자、잉격소수체양성가용내분비치료.치료결속후6~12개월유2위의사평분평개미용효과.결과 수방지2009년9월,수방솔위94.0%,수방만3、5년자분별위114、91례.전조3생존솔위99.1%,5년생존솔위96%,5년무류생존솔위88%,국부복발솔위3.6%,미용효과만의자위100%.방료중급방료결속후미출현명현방사성심폐등중요장기손상.결론 유선보유술+화료후흉벽동태조강방료사파구득도경균균조사,유망제고국부공제솔화생존솔병강저정상조직병발증、종류복발솔.
Objective To analyze the efficacy and cosmetic results of intensity modulate radiation therapy (IMRT) for breast cancer after breast-conserving surgery.Methods From 2003 to 2006, 117 patients with breast cancer, after breast-conserving surgery followed by 4 - 6 cycles of chemotherapy,received intensity modulated radiotherapy (IMRT) or three-dimensional conformal radiotherapy (3DCRT).The radiation dose was 50 Gy in 25 fractions to the whole breast and 10 Gy boost to the tumor bed.Patients with positive hormone receptors then received endocrine treatment.Results The follow-up rate was 94.0% until September 2009.114 and 91 patients were followed up to 3 and 5 years, respectively.The 3-and 5-year overall survival rates were 99.1% and 96%.The 5-year disease free survival and local recurrence rates were 88% and 3.6%.Cosmetic results were satisfied.Severe radiation toxicities, such as radiation pneumonitis, pulmonary fibrosis and heart injury were not found.Conclusions Patients treated with IMRT after breast-conserving surgery have a satisfied prognosis as well as cosmetic results.