中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2013年
2期
94-98
,共5页
蔡钢%梅欣%胡伟刚%陈兰飞%谢耩%俞晓立%杨昭志%潘自强%郭小毛%陈佳艺
蔡鋼%梅訢%鬍偉剛%陳蘭飛%謝耩%俞曉立%楊昭誌%潘自彊%郭小毛%陳佳藝
채강%매흔%호위강%진란비%사강%유효립%양소지%반자강%곽소모%진가예
乳腺肿瘤/三维适形放射疗法%加速部分乳腺照射%乳腺肿瘤/外科学%乳房切除术,区段%治疗结果
乳腺腫瘤/三維適形放射療法%加速部分乳腺照射%乳腺腫瘤/外科學%乳房切除術,區段%治療結果
유선종류/삼유괄형방사요법%가속부분유선조사%유선종류/외과학%유방절제술,구단%치료결과
Breast neoplasms/three-dimensional radiotherapy%Accelerated partial breast irradiation%Breast neoplasms/surgery%Mastectomy,segmental%Treatment outcome
目的 分析早期低危乳腺癌保乳术后三维适形加速部分乳腺照射(APBI)的局部控制情况、美容评价及不良反应,并对剂量学结果进行质量评估.方法 2008-2010年前瞻性临床Ⅱ期研究入组39例早期(0～Ⅰ期)乳腺癌保乳术后患者,其中浸润性导管癌28例、导管原位癌5例、其他类型浸润性癌6例.放疗处方剂量为38.5 Gy分10次,2次/d,间隔6h以上.不良反应评价采用NCI-CTC 3.0标准,美容评价依据Harris美容级别标准.结果 三维适形APBI技术应用于早期乳腺癌保乳术后获得了满意的剂量学结果,85％(33例)患者完全满足放疗质量控制评估标准.与ASTRO、GEC-ESTRO共识比较中危/高危患者比例分别为46％、18％和31％、3％.随访率100％,无一局部复发,无3、4级不良反应.放疗后6个月美容评价优异加良好者占90％(35例).结论 三维适形APBI入组患者选择恰当,局部控制、不良反应和美容评价初步结果较好.
目的 分析早期低危乳腺癌保乳術後三維適形加速部分乳腺照射(APBI)的跼部控製情況、美容評價及不良反應,併對劑量學結果進行質量評估.方法 2008-2010年前瞻性臨床Ⅱ期研究入組39例早期(0～Ⅰ期)乳腺癌保乳術後患者,其中浸潤性導管癌28例、導管原位癌5例、其他類型浸潤性癌6例.放療處方劑量為38.5 Gy分10次,2次/d,間隔6h以上.不良反應評價採用NCI-CTC 3.0標準,美容評價依據Harris美容級彆標準.結果 三維適形APBI技術應用于早期乳腺癌保乳術後穫得瞭滿意的劑量學結果,85％(33例)患者完全滿足放療質量控製評估標準.與ASTRO、GEC-ESTRO共識比較中危/高危患者比例分彆為46％、18％和31％、3％.隨訪率100％,無一跼部複髮,無3、4級不良反應.放療後6箇月美容評價優異加良好者佔90％(35例).結論 三維適形APBI入組患者選擇恰噹,跼部控製、不良反應和美容評價初步結果較好.
목적 분석조기저위유선암보유술후삼유괄형가속부분유선조사(APBI)적국부공제정황、미용평개급불량반응,병대제량학결과진행질량평고.방법 2008-2010년전첨성림상Ⅱ기연구입조39례조기(0～Ⅰ기)유선암보유술후환자,기중침윤성도관암28례、도관원위암5례、기타류형침윤성암6례.방료처방제량위38.5 Gy분10차,2차/d,간격6h이상.불량반응평개채용NCI-CTC 3.0표준,미용평개의거Harris미용급별표준.결과 삼유괄형APBI기술응용우조기유선암보유술후획득료만의적제량학결과,85％(33례)환자완전만족방료질량공제평고표준.여ASTRO、GEC-ESTRO공식비교중위/고위환자비례분별위46％、18％화31％、3％.수방솔100％,무일국부복발,무3、4급불량반응.방료후6개월미용평개우이가량호자점90％(35례).결론 삼유괄형APBI입조환자선택흡당,국부공제、불량반응화미용평개초보결과교호.
Objective To assess the clinical effects of accelerated partial breast irradiation (APBI)using three-dimensional conformal radiotherapy (3DCRT) in patients with low-risk early breast cancer after breast-conserving therapy (BCT) with respect to dosimetric parameters,local control,toxicities,and cosmetic outcome.Methods Thirty-nine patients with early breast cancer (stage 0-1) were enrolled in a prospective phase Ⅱ trial of APBI using 3DCRT in 2008-2010.Of all the patients,28 had invasive ductal carcinoma,5 had ductal carcinoma in situ,and 6 had other types of invasive carcinoma.The prescribed dose was 38.5 Gy/10 fractions twice daily,with an inter-fraction interval greater than 6 h.The toxicities were assessed according to the National Cancer Institute Common Toxicity Criteria,version 3.0.The cosmetic outcome was assessed according to the Harris breast cosmesis scale.Results The planning target volume coverage and normal-tissue dosimetry were appropriate in the APBI using 3DCRT.Dose homogeneity without deviation was achieved in 33 patients (85％).Of the total 39 patients,46％ met ASTRO's "cautionary" criteria,and 18％ met" unsuitable" criteria; also,31％ met GEC-ESTRO's" intermediate-risk" criteria,and 3％ met" high-risk" criteria.The follow-up rate was 100％.No patient experienced local recurrence,and no grade 3-4 toxicities were found.Cosmesis was good to excellent in 35 patients (90％)at 6 months after APBI.Conclusions The patients with early breast cancer after BCT are properly selected for APBI using 3DCRT,with satisfactory preliminary assessment results for local control,toxicities,and cosmetic outcome.
