CAJ | 학술논문

目的观察早期乳腺癌保乳术后大分割三维放疗的疗效、美容效果和不良反应.方法 2009-2010年45例pTis-2No-1M0期乳腺癌患者保乳术后行三维适形或简化调强放疗,全乳43.5 Gy,瘤床补量8.7Gy,2.9 Gy/次,总疗程24 d.33例接受了化疗,其中新辅助化疗2例、术后化疗31例.局部区域控制率和总生存率用Kapian-Meier法计算.结果随访率100％.2年局部区域控制率、生存率均为100％；1例单发骨转移.2级乳房水肿1例,2级乳房纤维化6例,2级上肢水肿1例.2级放射性皮炎4例,1、2级放射性肺炎分别为5、2例.与同期保乳术后常规分割放疗相比,放疗次数由30次降至18次,疗程由40 d缩短至24 d,费用由30450元降至19770元.结论乳腺癌保乳术后全乳大分割放疗的疗效和美容效果较好,不良反应可接受,且能显著降低治疗时间和费用.
목적 관찰조기유선암보유술후대분할삼유방료적료효、미용효과화불량반응.방법 2009-2010년45례pTis-2No-1M0기유선암환자보유술후행삼유괄형혹간화조강방료,전유43.5 Gy,류상보량8.7Gy,2.9 Gy/차,총료정24 d.33례접수료화료,기중신보조화료2례、술후화료31례.국부구역공제솔화총생존솔용Kapian-Meier법계산.결과 수방솔100％.2년국부구역공제솔、생존솔균위100％；1례단발골전이.2급유방수종1례,2급유방섬유화6례,2급상지수종1례.2급방사성피염4례,1、2급방사성폐염분별위5、2례.여동기보유술후상규분할방료상비,방료차수유30차강지18차,료정유40 d축단지24 d,비용유30450원강지19770원.결론 유선암보유술후전유대분할방료적료효화미용효과교호,불량반응가접수,차능현저강저치료시간화비용.
Objective To observe the therapeutic effects,cosmetic results,and toxicities of central hypofractionated three-dimensional radiotherapy for patients with early-stage breast cancer after breastconserving surgery.Methods From February 2009 to February 2010,45 patients with pTis-2N0-1 M0 breast cancer after breast-conserving surgery were enrolled in the trial.Three-dimensional conformal radiotherapy or simplified intensity-modulated radiotherapy was applied to each patient.The hypofractionated radiotherapy schedule was 43.5 Gy/15 fractions/3 weeks to the whole breast,with a boost of 8.7 Gy/3 fractions/3 days to the tumor bed.The dose was 2.9 Gy per fraction;the total course of treatment was 24 days.Thirty-three patients received chemotherapy,including neoadjuvant chemotherapy in 2 patients and postoperative adjuvant chemotherapy in 31 patients.Locoregional control and overall survival were calculated by Kaplan-Meier method.Results The follow-up rate was 100％.The 2-year locoregional control and overall survival were both 100％,and one patient had a single bone metastasis.Of the patients,1 developed grade 2 breast edema,6 developed grade 2 breast fibrosis,1 developed grade 2 upper extremity edema,4 developed grade 2 radiation dermatitis,5 developed grade 1 radiation pneumonitis,and 2 developed grade 2 radiation pneumonitis.Compared with the conventional fractionated radiotherapy for the patients with early-stage breast cancer after breast-conserving surgery,the hypofractionated three-dimensional radiotherapy had the number of fractions decreased from 30 to 18,course of treatment shortened from 40 days to 24 days,and the cost cut from ￥ 30450 to ￥ 19770.Conclusions The central hypofractionated three-dimensional radiotherapy for the patients with early-stage breast cancer after breast-conserving surgery have good therapeutic effects and cosmetic results and acceptable toxicities,as well as significantly reduced time and cost of treatment.