乳腺癌改良根治术后大分割放疗Ⅰ～Ⅱ期临床试验的近期结果

Postmastectomy hypofractionation radiotherapy in high-risk breast cancer patients： A phase Ⅰ / Ⅱ clinical trial

目的探讨乳腺癌改良根治术后大分割放疗的近期疗效和副反应。方法38例高危乳腺癌患者改良根治术后化疗后，同侧胸壁和锁骨上下放疗43．5Gy分15次3周完成，观察急性放疗反应发生率和肿瘤的局部区域控制率。结果中位随访13个月，入组38例患者全部生存，无照射野内复发，远处转移率为13％（5例）。5例患者出现3级放射性皮炎，均发生在放疗结束后2—3周。3例患者出现2级放射性肺炎。结论乳腺癌改良根治术后43．5Gy分15次3周完成的大分割放疗方案的急性副反应可以接受，近期疗效较好。

Objective To investigate the efficacy and toxicity of postmastectomy hypofractionation radiotherapy in patients with high-risk breast cancer. Methods Postmastectomy radiation of 43.5 Gy in 15 fractions of 2.9 Gy over 3 weeks was delivered to 38 patients with breast cancer. The incidence of acute radiation toxicity and locoregional recurrence was evaluated. Results With a median follow up of 13 months, all patients were alive. No patient had locoregional recurrence within radiation field. Five （ 13% ） had distant metastases. Five （ 13% ） developed grade 3 radiation dermatitis at 2 to 3 weeks after the course of radiation. Three （8%） had grade 2 radiation pneumonitis. Conclusions Hypofractionation radiation of 43.5 Gy in 15 fractions of 2.9 Gy over 3 weeks is effective in the near time for patients with high-risk breast cancer after mastectomy, and the acute toxicities are tolerable.