CAJ | 학술논문

目的观察早期乳腺癌保乳术后部分乳腺快速调强放疗的临床可行性.方法 2008年1月至2010年1月北京大学肿瘤医院收治的26例低危复发风险的早期乳腺癌保乳手术后的患者,实施部分乳腺快速逆向动态调强照射,处方剂量为34 Gy,10次5d完成.评价急性放射性皮肤反应,随访其临床疗效.结果 26例患者均按预定计划完成放疗,放疗期间10例患者出现轻度1级急性放射性皮肤反应(皮肤温度升高),放疗结束后1个月,26例患者均出现1级急性放射性皮肤反应(轻度色素沉着),无1级以上急性放射性皮肤反应；放疗结束后3个月患者皮肤反应基本消失.中位随访期51(35 ～59)个月,随访期满3年的23例,随访期内均未发现局部复发,3年无病生存率100％.2年的美容效果优良率为100％.结论早期乳腺癌保乳术后部分乳腺快速调强放疗急性毒性反应小,可获得满意的美容效果和临床疗效.
목적 관찰조기유선암보유술후부분유선쾌속조강방료적림상가행성.방법 2008년1월지2010년1월북경대학종류의원수치적26례저위복발풍험적조기유선암보유수술후적환자,실시부분유선쾌속역향동태조강조사,처방제량위34 Gy,10차5d완성.평개급성방사성피부반응,수방기림상료효.결과 26례환자균안예정계화완성방료,방료기간10례환자출현경도1급급성방사성피부반응(피부온도승고),방료결속후1개월,26례환자균출현1급급성방사성피부반응(경도색소침착),무1급이상급성방사성피부반응；방료결속후3개월환자피부반응기본소실.중위수방기51(35 ～59)개월,수방기만3년적23례,수방기내균미발현국부복발,3년무병생존솔100％.2년적미용효과우량솔위100％.결론 조기유선암보유술후부분유선쾌속조강방료급성독성반응소,가획득만의적미용효과화림상료효.
Objective To explore the clinical feasibility of accelerated partial breast irradiation (APBI) by intensity-modulated radiotherapy (IMRT).Methods Twenty-six patients with T1N0M0 breast cancer were enrolled into a prospective accelerated partial-breast IMRT protocol between January 2008 and January 2010.Inverse planning of IMRT was employed at a prescribed dose of 34 Gy/10 f/5 d.Acute radiation skin responses and clinical effects were observed.Results All of them completed radiation.During the radiation,Grade 1 of acute radiation skin reaction (mild hyperpigmentation) was seen in 8 patients and there was not ＞ grade 2 of skin reaction.At Month 1 post-radiation,Grade 1 of acute radiation skin reaction (mild hyperpigmentation) was seen in all patients and there was not ＞ grade 2 of skin reaction.At Month 3 post-radiation,all instances of acute radiation skin reactions recovered.The median follow-up period was 51 months (range:35-59).The follow-up period of 23 patients were over 3 years.No local recurrences developed.The 3-year disease-free survival was 100％.Cosmesis was good or excellent in all cases at Year 2.Conclusion External beam-partial breast irradiation delivered by IMRT is feasible for selected Chinese early-stage breast cancer patients after breast-conserving surgery.The cosmetic effect,local control rate and long-term survival rate are satisfactory.And acute radiation toxicity is quite low.