调强放疗与二维放疗在乳腺癌根治术后患者中的应用效果及安全性比较

Comparison of application effect and safety of intensity modulated radiotherapy and two-dimensional radiotherapy in patients after radical mastectomy

目的比较调强放疗与二维放疗在乳腺癌根治术后患者中的应用效果及安全性。方法选取2015年1月至2017年12月在我院进行根治术治疗的80例乳腺癌患者,根据抽签法将其随机分为对照组和观察组,各40例。对照组采取二维放疗,观察组采取调强放疗。比较两组的不良反应发生情况,3年内肿瘤转移率、复发率及病死率,治疗前、后的FACT-B评分及心功能指标。结果观察组的不良反应总发生率低于对照组,差异具有统计学意义(P<0.05)。随访3年内,观察组的肿瘤转移率和复发率低于对照组,差异具有统计学意义(P<0.05);两组的病死率无显著差异(P>0.05)。治疗后,两组的FACT-B各项评分均升高,且观察组高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的EF高于对照组,LADs和LVDd小于对照组,差异具有统计学意义(P<0.05)。结论与二维放疗比较,调强放疗在乳腺癌根治术后患者中的应用效果及安全性更确切,且还可有效提升患者的生存质量,值得临床应用和推广。

Objective To compare the application effect and safety of intensity modulated radiotherapy and two-dimensional radiotherapy in patients after radical mastectomy.Methods Eighty patients with breast cancer treated by radical mastectomy in our hospital from January 2015 to December 2017 were selected and randomly divided into control group and observation group by drawing lots method,with 40 cases in each group.The control group received two-dimensional radiotherapy,and the observation group received intensity modulated radiotherapy.The adverse reactions,tumor metastasis rate,recurrence rate and mortality within 3 years,FACT-B score and cardiac function indexes before and after treatment were compared between the two groups.Results The total incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Within 3 years of follow-up,the tumor metastasis rate and recurrence rate in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05);and there was no significant difference in mortality between the two groups(P>0.05).After treatment,the FACT-B scores in the two groups increased,and those in the observation group were higher than the control group,and the differences were statistically significant(P<0.05).After treatment,the EF in the observation group was higher than that in the control group,the LADs and LVDd were smaller than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with two-dimensional radiotherapy,intensity modulated radiotherapy is more effective and safer for patients after radical mastectomy,and can effectively improve the quality of life of patients,which is worthy of clinical application and promotion.