CAJ | 학술논문

目的：观察 T1－2 N0－1 M0期乳腺癌保乳术后大分割调强放疗的疗效、美容效果及不良反应。方法：选择2011年11月－2012年11月间就诊于山西省肿瘤医院乳腺疾病诊治中心的乳腺癌保乳患者41例，予大分割调强放疗，全乳计划靶体积43．5Gy／15次，瘤床区电子线补量8．7Gy／3次，2．9Gy／次，5次／周，疗程共24天。局部区域控制率和总生存率用 Kaplan －Meier 法计算。结果：中位随访时间27个月，随访率100％。3年局部区域控制率、生存率均为100％，急性放射性皮肤反应Ⅰ级4例，Ⅱ级3例；血液系统不良反应白细胞下降Ⅰ级5例，Ⅱ级3例，Ⅲ级2例；急性放射性肺炎 I 级2例，晚期放射性肺炎1例；患肢水肿轻度2例。放疗前、后美容效果评价优秀＋良好率为95．1％、87．8％，放疗后1、3、6、12个月优秀＋良好率均为90．2％。结论：早期乳腺癌保乳术后调强大分割放疗疗效和美容效果较好，且不良反应发生率低，可以缩短放疗时间。
목적：관찰 T1－2 N0－1 M0기유선암보유술후대분할조강방료적료효、미용효과급불량반응。방법：선택2011년11월－2012년11월간취진우산서성종류의원유선질병진치중심적유선암보유환자41례，여대분할조강방료，전유계화파체적43．5Gy／15차，류상구전자선보량8．7Gy／3차，2．9Gy／차，5차／주，료정공24천。국부구역공제솔화총생존솔용 Kaplan －Meier 법계산。결과：중위수방시간27개월，수방솔100％。3년국부구역공제솔、생존솔균위100％，급성방사성피부반응Ⅰ급4례，Ⅱ급3례；혈액계통불량반응백세포하강Ⅰ급5례，Ⅱ급3례，Ⅲ급2례；급성방사성폐염 I 급2례，만기방사성폐염1례；환지수종경도2례。방료전、후미용효과평개우수＋량호솔위95．1％、87．8％，방료후1、3、6、12개월우수＋량호솔균위90．2％。결론：조기유선암보유술후조강대분할방료료효화미용효과교호，차불량반응발생솔저，가이축단방료시간。
Objective:To observe the efficacy,cosmetic outcome and adverse reaction of hypofractionated intensity-modulated radiotherapy for T1 -2 N0 -1 M0 breast cancer after breast conserving surgery.Methods:From November 2011 to November 2012,41 patients with T1 -2 N0 -1 M0 breast cancer after breast conserving surgery in Shanxi Tumor Hospital were enrolled in the trial.The hypofractionated intensity -modulated radiotherapy was applied to each pa-tient.The hypofractionated intensity -modulated radiotherapy was 43.5Gy/(15f·3w)to the whole breast,with a boost of 8.7Gy/(3f·3d)to the tumor bed.The dose was 2.9Gy per fraction,the total course of treatment was 24 days.Locoregional control and overall survival were calculated by Kaplan -Meier method.Results:The follow -up rate was 100%,the 3 -year locoregional control and overall survival were both 100%.4 developed grade Ⅰ acute ra-diodermatitis,3 developed grade Ⅱ acute radiodermatitis,5 developed grade Ⅰ leukocyte reduction,3 developed grade Ⅱ leukocyte reduction,2 developed grade Ⅲ leukocyte reduction,2 developed grade Ⅰ acute radioactive pneu-monia,1 developed grade late radioactive pneumonia,2 developed grade Ⅰ limb edema.The excellent and good rates of cosmetic outcomes before and after radiotherapy were 95.1%,87.8%,The 1 -,3 -,6 -,12 -month excellent and good rates of cosmetic outcomes after radiotherapy were 90.2%.Conclusion:The hypofractionated intensity -modula-ted radiotherapy for the patients with early -stage breast cancer after breast -conserving surgery have good therapeu-tic effects and cosmetic results,acceptable toxicities,low adverse reaction,as well as can shorten the time of radiother-apy.