CAJ | 학술논문

目的：观察早期乳腺癌保乳术后大分割调强放疗（ h-IMRT）的美容效果。方法收集潍坊市人民医院2009年2月～2013年1月67例女性早期乳腺癌保乳术后患者，根据患者意愿入组三维适形放疗（3DCRT）、常规分割调强放疗（IMRT）或h-IMRT组。3DCRT组：采用6MV-X线切线野照射，全乳腺50Gy/25次/5周，然后行瘤床区9/12 MeV电子线补量10 Gy/5 F/1周；IMRT组：采用逆向动态调强技术，全乳腺50 Gy/25次/5周，瘤床区用X线同步加量60Gy/25次/5周，或全乳腺放疗结束后行电子线补量（方式及剂量同3DCRT）；h-IM-RT组：全乳腺42．5Gy/16F/22d，瘤床区同步加量48Gy/16F/22d。结果短期随访结果示，早期乳腺癌保乳术后患者大分割调强放疗组可以明显缩短放疗时间，未降低美容效果，未增加局部复发风险。结论大分割IMRT很有可能成为中国女性早期乳腺癌保乳术后安全有效的放疗模式。
목적：관찰조기유선암보유술후대분할조강방료（ h-IMRT）적미용효과。방법수집유방시인민의원2009년2월～2013년1월67례녀성조기유선암보유술후환자，근거환자의원입조삼유괄형방료（3DCRT）、상규분할조강방료（IMRT）혹h-IMRT조。3DCRT조：채용6MV-X선절선야조사，전유선50Gy/25차/5주，연후행류상구9/12 MeV전자선보량10 Gy/5 F/1주；IMRT조：채용역향동태조강기술，전유선50 Gy/25차/5주，류상구용X선동보가량60Gy/25차/5주，혹전유선방료결속후행전자선보량（방식급제량동3DCRT）；h-IM-RT조：전유선42．5Gy/16F/22d，류상구동보가량48Gy/16F/22d。결과단기수방결과시，조기유선암보유술후환자대분할조강방료조가이명현축단방료시간，미강저미용효과，미증가국부복발풍험。결론대분할IMRT흔유가능성위중국녀성조기유선암보유술후안전유효적방료모식。
Objective To observe short-term cosmetic outcome of hypofractionated intensity-modulated ra-diotherapy ( h-IMRT) in patients with early-stage breast cancer after breast-conserving surgery .Methods Sixty-seven women cases with early-stage breast cancer after breast-conserving were collected in Weifang People's Hospital from Feb-ruary 2009 to January 2013,and divided into three group:three-dimensional conformal radiotherapy (3DCRT),the con-ventional fractioned intensity modulated radiotherapy ( IMRT) ,and the hypofractionated intensity-modulated radiotherapy (h-IMRT) according to the patient's attention.For 3DCRT and IMRT group,the whole affected-side breast was delivered 5 days a week to a dose of 50 Gy in 25 fractions using 6 MV photons adopting tangential field irradiation or reverse dy-namic intensity modulated technology respectively , then tumor bed ( the lumpectomy site with a 1 ~2 cm margin or the breast scars with a 2~3cm margin) was boosted by 9/12MeV electron beam to a dose of 10Gy 5 days a week in 5 frac-tions or was done concomitantly using 6 MV photons to a dose of 10 Gy in 25 fractions for IMRT group;For h-IMRT group:the whole breast was delivered 5 days a week to a dose of 42.5Gy in 16 fractions using 6 MV photons adopting re-verse dynamic intensity modulated technology ,concomitant boost to the tumor bed was delivered to a total dose of 48Gy in 16 fractions.Results Short-term follow-up results indicated radiotherapy course was significantly shortened in h-IM-RT group,the risk of local recurrence were not increased ,cosmetic outcome was retained .Conclusion It is a possibility to treat Chinese women with early-stage breast cancer after breast-conserving surgery adopting h-IMRT technology safely and effectively .