CAJ | 학술논문

目的探讨接受保乳手术后的早期浸润性乳腺癌患者分别接受大分割和超分割放疗以后在无病生存时间、不良反应等方面是否存在差异。方法将我科收治的60例接受保乳手术后的浸润性乳腺癌患者分为常规分割放疗（CRT ）组和大分割放疗（HOFRT ）组，每组30例，CRT 组接受常规分割放疗，即接受2 Gy／次，1次／d ，5次／周，总量50 Gy ，25次，5周完成照射，HOFRT组接受大分割放疗，即接受3.4 Gy／次，1次／d ，5次／周，总量44.2 Gy ，13次，2.5周完成照射，并跟踪随访，记录不良反应发生情况和无病生存时间，采用Kaplan‐M eier法比较2种分割剂量的无病生存时间是否有差异，采用两独立样本秩和检验比较2组患者不良反应发生情况是否有差异。结果 CRT组患者中位无病生存时间为89.9个月，HOFRT 组患者中位无病生存时间为93个月，2组患者生存时间差异无统计学意义（ P＞0.05）。2组患者的不良反应存在差异，在急性皮肤反应和骨髓抑制方面大分割放疗较常规分割放疗严重（ P＜0.05）。结论2组患者无病生存时间差异无统计学意义，但治疗后的不良反应的差异存在统计学意义，HOFRT组患者不良反应更严重，故应根据患者经济条件及身体基本情况具体制订分割方案，对于身体情况较差，不急于化疗的患者推荐使用常规分割放疗，对于身体基本条件较好的患者，可选用大分割放疗，尽早化疗，以提高疗效。
목적탐토접수보유수술후적조기침윤성유선암환자분별접수대분할화초분할방료이후재무병생존시간、불량반응등방면시부존재차이。방법장아과수치적60례접수보유수술후적침윤성유선암환자분위상규분할방료（CRT ）조화대분할방료（HOFRT ）조，매조30례，CRT 조접수상규분할방료，즉접수2 Gy／차，1차／d ，5차／주，총량50 Gy ，25차，5주완성조사，HOFRT조접수대분할방료，즉접수3.4 Gy／차，1차／d ，5차／주，총량44.2 Gy ，13차，2.5주완성조사，병근종수방，기록불량반응발생정황화무병생존시간，채용Kaplan‐M eier법비교2충분할제량적무병생존시간시부유차이，채용량독립양본질화검험비교2조환자불량반응발생정황시부유차이。결과 CRT조환자중위무병생존시간위89.9개월，HOFRT 조환자중위무병생존시간위93개월，2조환자생존시간차이무통계학의의（ P＞0.05）。2조환자적불량반응존재차이，재급성피부반응화골수억제방면대분할방료교상규분할방료엄중（ P＜0.05）。결론2조환자무병생존시간차이무통계학의의，단치료후적불량반응적차이존재통계학의의，HOFRT조환자불량반응경엄중，고응근거환자경제조건급신체기본정황구체제정분할방안，대우신체정황교차，불급우화료적환자추천사용상규분할방료，대우신체기본조건교호적환자，가선용대분할방료，진조화료，이제고료효。
Objective To investigate the differences in disease free survival time ,adverse reaction between conventional radiotherapy and hypofractionated radiotherapy for early‐stage invasive breast cancer patients who have received breast conserving operation .Methods Sixty early‐stage invasive breast cancer patients who had re‐ceived breast conserving operation in our department were divided into CRT group and HOFRT group ,30 patients in each group .Group CRT received conventional radiotherapy ,accepting 2 Gy/time ,1 time/d ,5 times/week ,to‐tal 50 Gy ,25 times ,completed irradiation in 5 weeks .Group HOFRT received hypofractionated radiotherapy ,ac‐cepting 3 .4 Gy/time ,1 time/d ,5 times/week ,total 44 .2 Gy ,13 times ,completed irradiation in 2 .5 weeks .In follow‐up ,the occurrence of adverse reaction and disease free survival time were recorded .Kaplan‐Meier method was used to compare the disease free survival time between two groups .Two independent samples test method was used to compare the adverse reaction between two groups .Results The median disease free survival time of CRT group patients was 89 .9 months ,and the median disease free survival time of HOFRT group patients was 93 months .There was no significant difference between the survival time of two groups patients (P>0.05) .For ad‐verse reaction of two groups patients ,there are differences ,there are more serious reaction in the hypofractionated radiotherapy than the conventional radiotherapy in acute skin reaction and suppression of bone marrow ( P<0.05) .Conclusion Patients in the two groups had no significant difference in disease free survival time ,but has great difference in the adverse reaction after treatment .Patients in the HOFRT group had more severe toxicity re‐action .We should apply different treatments according to different financial condition and body condition of pa‐tients to improve the efficacy in treatments .For the patients who have weaker physical condition and aren't eager to chemotherapy ,we recommend the use of the conventional radiotherapy .For the patients who have good body quality ,we recommend the use of the hypofractionated radiotherapy and undergo chemotherapy as soon as possi‐ble .