大分割放疗治疗保乳手术后早期乳腺癌的疗效及安全性

Efficacy and safety of large fractionated radiotherapy for early stage breast cancer after breast-conserving surgery

目的探讨常规放疗与大分割放疗对行保乳手术早期乳腺癌患者的疗效及安全性。方法保乳手术早期乳腺癌患者共120例,以随机区组法分为常规放疗组(60例)和大分割放疗组(60例),术后分别行常规放疗(总放射剂量50 Gy/25 f,瘤床加量10 Gy/5 f)与大分割放疗(总放射剂量42.4 Gy/16 f,瘤床加量10 Gy/4 f)治疗。比较两组患者生存率、复发转移率、美容效果优良率及不良反应发生率等。结果两组患者1、2、3年生存率比较差异均无统计学意义(98.3%vs 100.0%,93.3%vs 96.7%,88.3%vs 90.0%,均P>0.05),3年局部复发率和远处转移率比较差异均无统计学意义(5.0%vs 1.7%,10.0%vs 6.7%,均P>0.05),美容效果优良率比较差异无统计学意义(88.3%vs 90.0%,P>0.05),不良反应发生率比较差异无统计学意义(P>0.05)。结论常规放疗与大分割放疗用于行保乳手术早期乳腺癌患者具有相似临床疗效及安全性,而大分割放疗方案具有放疗次数少、疗程短及经济性好等优势。

Objective To investigate the efficacy and safety of conventional fractionated radiotherapy and large fractionated radiotherapy for early stage breast cancer patients after breast-conserving surgery. Methods One-hundred-andtwenty early stage breast cancer patients after breast-conserving surgery were enrolled,which were randomly divided into conventional fractionated radiotherapy group（ 60 cases） and large fractionated radiotherapy group（ 60 cases）. Conventional fractionated radiotherapy group was treated with total radiation dose of 50 Gy /25 f and tumor bed addition dose of 10 Gy /5 f; large fractionated radiotherapy group was treated with total radiation dose of 42. 4 f Gy /16 f and tumor bed addition dose of 10 Gy /4 f. Survival rates,recurrent and metastatic rates,cosmetic outcomes and side effects were compared between two groups. Results There were no significant differences in survival rates of 1- 3 years（ 98. 3% vs 100. 0%,93. 3% vs96. 7%,88. 3% vs 90. 0%,all P〉0. 05）,3-year recurrent and metastatic rates（ 5. 0% vs 1. 7%,10. 0% vs 6. 7%,both P〉0. 05）,cosmetic outcomes（ 88. 3% vs 90. 0%,P〉0. 05）,and risks of side effects（ P〉0. 05） between two groups.Conclusion Conventional fractionated radiotherapy and large fractionated radiotherapy have similar clinical efficacy and safety in treating early stage breast cancer patients after breast-conserving surgery. However,large fractionated radiotherapy has advantages of less radiotherapy cycles,shorter treatment course and lower cost.