左侧胸部放疗对乳腺癌保乳术患者心功能及生活质量分的影响（英文）

Influence of left-thoracic radiotherapy on heart function and quality of life in patients with breast cancer after breast-conserving surgery

目的：观察左侧胸部放疗对乳腺癌保乳术患者的心功能及生活质量的影响。方法：连续选择新近接受乳腺癌保乳手术并进行了左侧胸部放射治疗的患者35例（放疗组），于放射治疗前、后接受了常规超声心动图（ECG）及组织多普勒（TDI）检测以及“中国心血管病人生活质量评定问卷（CQQC）”评估，并与31例同期接受乳腺癌根治术，且未接受胸部放疗患者（对照组）的检查结果进行比较。结果：两组对象放射治疗前ECG、TDI检查的左心功能指标，和cQQc量表各维度评分及CQQC总分无显著差异（P均〉0．05）。5周治疗后，与治疗前及对照组治疗后比较，放疗组的EF（0．90±0．32）cm／s比（0．90±0．38）cm／s比（0．86±0．29）（cm／s]，E／AE（1．28±0．46）比（1．28±0．45）比（1．20±0．38）]，及Em[（10．12±1．93）cm／s比（9．95±1．64）cm／s比（7．51±1．12）cm／s]，Em／Am[（1．25±0．26）比（1．24±0．23）比（0．90±0．15）]显著降低（P均〈0．05）；同时CQQC量表所有维度评分（P（0．05-〈0．01）及CQQC总分[（67．36±7．87）分比（63．75±7．26）分比（52．83±6．40）分]（P〈0．01）也明显减少。结论：接受左侧胸部放疗的乳腺癌保乳术患者常有左心功能及生活质量下降，应进行有针对性的康复治疗。

Objective： To observe the influence of left-thoracic radiotherapy on heart function and quality of life in patients with breast cancer after breast-conserving surgery. Methods： A total of 35 patients with breast cancer, who recently received breast-conserving surgery and left-thoracic radiotherapy, were continuously selected as radiotherapy group. They received routine echocardiography （ECG）, tissue Doppler imaging （TDI） and evaluation of Chinese questionnaire of quality of life in patients with cardiovascular diseases （CQQC） before and after radiotherapy. The results were compared with those of 31 patients （control group）, who received radical mastectomy without breast radiotherapy in the same period. Results： There were no significant difference in left heart function indexes by ECG and TDI, all dimensional and total scores of CQQC between two groups before radiotherapy （P〉0.05 all）. After five-week treatment, compared with evaluation before radiotherapy and control group after treatment, there were significant decrease in E [（0.90±0.32） cm/s vs. （0.90±0.38） cm/s vs. （0. 86±0.29） cm/s], E/A [（1.28±0.46） vs. （1.28±0.45） vs. （1.20＋0. 38）], Em [ （10.12±1.93） em/s vs. （9.95±1.64） cm/s vs. （7.51±1. 12）cm/s], Em/Am [ （1.25±0.26） vs. （1.24±0.23） vs. （0.90±0.15）] （P〈0. 05 all）, all dimensional scores （P〈0.05-〈 0.01） and total score [ （67.36±7.87） scores vs. （63.75±7.26） scores vs. （52.83±6.40） scores] （P〈0.01） of CQQC in radiotherapy group. Conclusion： There are often decrease in left heart function and quality of life in patients with breast cancer undergoing left-thoracic radiotherapy after breast-conserving surgery, so it＇s necessary to perform targeted rehabilitative treatment.