乳腺癌改良根治术后大分割放疗的研究

Clinical trial of postmastectomy hypofractionation radiotherapy in breast cancer

目的:探讨乳腺癌改良根治术后大分割放疗的疗效及不良反应。方法:2011年-2012年陕西省人民医院收治高危乳腺癌患者85例,行同侧胸壁和锁骨上下区照射,其中41例行大分割放疗(大分割组),DT42.56Gy/16f,总疗程22-24天;44例行常规分割放疗(常规组),DT 50Gy/25f,总疗程33-35天。观察肿瘤的局部控制率、远处转移率及急性放疗反应的发生率。结果:中位随访时间为15个月,随访率为100%。全组2年生存率均为100%,无照射野内复发。大分割组和常规组远处转移率分别为12.2%、11.4%(χ2=0.039,P=0.843)。大分割组和常规组1级白细胞减少、2级放射性皮炎、2级放射性肺炎发生率分别为24.4%与27.3%(χ2=0.092,P=0.762)、17.1%与13.6%(χ2=0.194,P=0.660)、4.9%与6.8%(χ2=0.144,P=0.704)。结论:乳腺癌改良根治术后大分割放疗的近期疗效与常规分割相似,急性毒副反应可以接受。

Objective:To investigate the efficacy and toxicity of hypofractionation radiotherapy in patients with breast cancer after postmastectomy.Methods:A total of 85 postmastectomy with breast cancer after postmastectomy were included,treated by ipsilateral chest wall and supraclavicular nodal radiation.41 patients received to 42.56Gy/16f,22-24 days(HF group),44 patients received to 50Gy/25f,33-35 days(CF group).The incidence of local con-trol,distant metastasis and acute radiation toxicity were evaluated.Results:After a median follow up of 15 months,the follow-up rate was 100%.The 2-year overall survival rate was 100%.No patient had locoregional recurrence within radiation field.The distant metastasis rates in HF and CF were 12.2%,11.4%(P=0.843).Grade 1 neutropenia oc-curred,developed grade 2 radiation dermatitis,developed grade 2 radiation pneumonitis in HF and CF were 24.4%vs 27.3%(P=0.762),17.1% vs 13.6%(P=0.660),4.9% vs 6.8%(P=0.704).Conclusion:Postmastectomy hypofractionation radiotherapy provides similar results to conventional radiotherapy in survival rate and toxicity.