CAJ | 학술논문

目的：观察同步加速调强放疗在早期乳腺癌保乳术后放疗的临床疗效和不良反应。方法：选择本院45例于2010年1月-2012年12月接受保留乳房手术切除的早期乳腺癌患者，按照随机数字表法分成研究组和对照组，研究组23例采用全乳放疗并同期加量放疗，1.8~2.4 Gy/d，每周5次。全乳腺照射45 Gy/25F，瘤床区总剂量60 Gy/25 F；对照组22例采用全乳放疗后局部瘤床加量，2 Gy/d，每周5次，全乳腺照射50 Gy/25 F，瘤床区局部加量10 Gy/5 F，总剂量60 Gy/30 F。按RTOG标准评估放疗反应，复发转移率的比较采用χ2检验。结果：两组患者中位随访18个月，研究组23例患者中，1例患者出现同侧锁骨上淋巴结转移，1例出现骨转移，复发转移率为8.70%。患者的放疗反应为1~2级，中位住院放疗时间为30 d。对组照22例患者中1例肝转移，其余均未出现复发和远处转移，复发转移率为4.55%。放疗反应为1~2级，中位住院放疗时间37 d。两组复发转移率比较差异无统计学意义（P=0.968）。结论：同步加速调放疗治疗早期乳腺癌保乳术后患者，缩短了治疗时间，临床疗效良好，放疗反应轻微，值得进一步临床研究及应用。
목적：관찰동보가속조강방료재조기유선암보유술후방료적림상료효화불량반응。방법：선택본원45례우2010년1월-2012년12월접수보류유방수술절제적조기유선암환자，안조수궤수자표법분성연구조화대조조，연구조23례채용전유방료병동기가량방료，1.8~2.4 Gy/d，매주5차。전유선조사45 Gy/25F，류상구총제량60 Gy/25 F；대조조22례채용전유방료후국부류상가량，2 Gy/d，매주5차，전유선조사50 Gy/25 F，류상구국부가량10 Gy/5 F，총제량60 Gy/30 F。안RTOG표준평고방료반응，복발전이솔적비교채용χ2검험。결과：량조환자중위수방18개월，연구조23례환자중，1례환자출현동측쇄골상림파결전이，1례출현골전이，복발전이솔위8.70%。환자적방료반응위1~2급，중위주원방료시간위30 d。대조조22례환자중1례간전이，기여균미출현복발화원처전이，복발전이솔위4.55%。방료반응위1~2급，중위주원방료시간37 d。량조복발전이솔비교차이무통계학의의（P=0.968）。결론：동보가속조방료치료조기유선암보유술후환자，축단료치료시간，림상료효량호，방료반응경미，치득진일보림상연구급응용。
Objective:To observe the synchrotron intensity modulated radiotherapy in patients after Breast-conserving surgery of early-stage breast cancer clinical effectiveness and toxicity.Method:Forty-five patients who had received breast-conserving surgery for early breast cancer patients in our hospital from January 2010 to December 2012 were randomly assigned to the study group and the control group. Twenty-three patients of the study group were given whole breast radiotherapy and radiotherapy plus the amount of the same period,1.8-2.4 Gy/d,5 times a week. The total dose of whole breast irradiation was 45 Gy/25F,and total dose of tumor-bed was 60 Gy/25F. Twenty-two cases of the control group were given electronic beam after the whole breast radiotherapy to increase the amount of local tumor bed,2 Gy/d,5 times a week. The total dose of whole breast irradiation 50 Gy/25F,increasing the amount of local tumor-bed dose of 10 Gy/5F, total dose 60 Gy/30F. According to RTOG criteria assessed the toxicity reactions,compared the recurrence rate using χ2 test. Result:Two groups of patients with a median follow-up of 18 months. Twenty-three patients in the study group,1 patient had ipsilateral supra clavicular lymph node metastasis,1 case with bone metastasis,recurrence and metastasis rate was 8.70%. Patients with radiation toxicity were mostly grade 1 or 2,with a median time of 30 days hospitalization. Twenty-two patients in the control group had 1 patient with liver metastasis,the recurrence and metastasis rate was 4.55%. Patients with radiation toxicity were mostly grade 1 or 2,with a median time of radiotherapy 37 days hospitalization. Between the two groups of patients recurrence rate,there was no significant difference(P=0.968).Conclusion:The synchrotron intensity modulated radiotherapy in patients after breast-conserving surgery for early-stage of breast cancer has good clinical effect,and the adverse events are tolerable,more efforts should be made to confirm these results.