大分割放疗在早期乳腺癌保乳根治术后的临床应用效果

Clinical Application Effect of Hypofractionated Radiotherapy After Breast-Conserving Radical Mastectomy for Early Breast Cancer

目的探讨大分割放疗和常规分割放疗在早期乳腺癌保乳根治术后的临床应用效果。方法选择2017年1月至2018年12月在郑州大学第五附属医院行保乳根治术的92例早期乳腺癌患者作为研究对象,根据放疗方法分为观察组(47例)和对照组(45例)。对照组患者接受常规分割放疗方案,观察组患者接受大分割放疗方案。对两组患者乳腺美容效果、不良反应以及放疗效果进行评价。结果观察组乳腺美容效果优20例、良18例、一般7例、差2例;对照组优19例、良16例、一般8例、差2例。两组患者美容效果比较,差异无统计学意义(P>0.05)。观察组放疗后急性皮肤反应、骨髓抑制、食管黏膜反应以及放射性肺炎等不良反应发生率(分别为89.36%、61.70%、19.15%和4.26%)与对照组(分别为91.11%、66.67%、22.22%和6.67%)比较,差异无统计学意义(P>0.05)。两组患者均于放疗后随访2 a,观察组局部复发率(4.26%)和对照组(4.44%)比较,差异无统计学意义(P>0.05);两组患者均全部生存。结论大分割放疗可有效缩短放疗次数和疗程,并且在乳腺美容效果、放疗安全性与临床效果等方面的评价结果与常规放疗相当。

Objective To explore the clinical application effect of hypofractionated radiotherapy and conventional fractionated radiotherapy after breast-conserving radical mastectomy for early breast cancer.Methods A total of 92 early breast cancer patients who underwent breast-conserving radical mastectomy in the Fifth Affiliated Hospital of Zhengzhou University from January 2017 to December 2018 were selected as the research object.According to the radiotherapy method,they were divided into observation group(47 cases)and control group(45 cases).Patients in the control group were received conventional fractional radiotherapy,and patients in the observation group were received hyperfractionated radiotherapy.The breast cosmetic effect,adverse reaction and the effect of radiotherapy in the two groups were evaluated.Results The evaluation results of breast cosmetic effect in the observation group were excellent in 20 cases,good in 18 cases,fair in 7 cases,and poor in 2 cases,and the evaluation results in the control group were excellent in 19 cases,good in 16 cases,fair in 8 cases,and poor in 2 cases.There was no difference in cosmetic effect evaluation between the two groups(P>0.05).The incidences of acute skin reaction,bone marrow suppression,esophageal mucosal reaction,and radiation pneumonia after radiotherapy in the observation group were 89.36%,61.70%,19.15%,and 4.26%,and the control group were 91.11%,66.67%,22.22%,and 6.67%.There were no differences in adverse reactions between the two groups(P>0.05).There was no difference in the local recurrence rate between the observation group(4.26%)and the control group(4.44%)during the 2-year follow-up(P>0.05),and all patients in the two groups survived.Conclusion Hypofractionated radiotherapy could effectively shorten the frequency and duration of radiotherapy,and the evaluation results of breast cosmetic effect,radiotherapy safety and clinical effect were equivalent to conventional radiotherapy.