乳腺癌术后锁骨腋窝照射野改进的临床价值

Value of modification of supraclavicular-axillary irradiation after mastectomy for breast cancer

目的 改进乳腺癌术后锁骨腋窝照射野的技术 ,减少肺部放射性损伤的发生。方法 对乳腺癌术后放射治疗的 5 0例患者锁骨腋窝野下界进行改进 ,并与常规野放射治疗的 111例患者进行对比 ,观察并分析两者对肺损伤的影响。结果 改进后减少肺照射面积 2 2 .49cm2 (t =2 0 .87,P <0 .0 0 1)。减少肺照射体积 5 5 .30cm3 (t=6 5 .37,P <0 .0 0 1) ,肺的放射性损伤显著降低 ,区域淋巴结转移无增加。结论 锁骨腋窝野下界缩小 。

Objective To reduce the lung injury by modification of supraclavicular axillary irradiation after mastectomy for breast cancer. Methods The effect of supraclavicular axillary field on radiation induced lung injury was analyzed in 111 patients treated with routine supraclavicular axillary field compared to 50 patients with modified lower border of supraclavicular axillary field. Results The irradiated lung volume was decreased from 55.3 cm2 to 22.5 cm2 (P<0.001) after modification of the supraclavicular axillary field. The radiation induced lung injury was significantly decreased without increase of the locoregional lymphatic metastasis. Conclusions The modified inferior border of supraclavicular axillary field decreases the radiation induced lung damage and is effective in controlling the locoreginal lymphatic metastasis.