调强放疗下大分割在乳腺癌保乳术后放疗中的疗效观察

Effects of intensity-modulated radiotherapy on hyperfractionation of breast cancer after breast-conserving surgery

目的 观察调强放疗(intensity modulated radiation therapy,IMRT)下大分割在乳腺癌保乳术后放疗中的疗效。方法 采取前瞻性研究,选取2018年12月至2019年12月江南大学附属医院放疗科收治的100例乳腺癌保乳术后患者作为研究对象,按照数字表法随机将其分为大分割组和常规分割组,每组各50例。大分割组进行低分次大分割放疗,常规分割组接受常规分割放疗。比较2组患者美容效果、放疗反应、住院时间、放疗费用、1年预后,以及比较治疗前及治疗3个月后2组乳腺癌患者生存质量测定量表(FACT-B)评分。结果 2组患者美容效果比较差异无统计学意义(P>0.05);治疗期间2组患者均无2级以上放疗反应发生,2组患者急性期皮肤反应、骨髓抑制、放射性肺炎、食管黏膜反应发生率比较,差异无统计学意义(P>0.05);大分割组患者住院时间及放疗费用均少于常规分割组(P<0.05);治疗前后2组患者FACT-B各维度评分比较差异无统计学意义(P>0.05),但治疗后2组患者FACT-B评分均显著高于治疗前(P<0.05);2组患者1年生存率比较差异无统计学意义(P>0.05)。结论 IMRT下大分割在乳腺癌保乳术后放疗中能改善患者生活质量,缩短其住院时间,减轻其经济负担。

Objective To observe the effects of intensity-modulated radiotherapy(IMRT) on hyperfractionation of breast cancer after breast-conserving surgery.Methods A prospective study was performed and a total of 100 female patients with breast cancer after breast-conserving surgery admitted to the Department of Radiotherapy,Affiliated Hospital of Jiangnan University from December 2018 to December 2019 were enrolled as research subjects.The patients were randomly divided into the large segmentation group and the conventional segmentation group,each consisting of 50.The large segmentation group received low-fractionated/highfractionated radiotherapy,while the conventional segmentation group just received conventional fractionated radiotherapy.The cosmetic effect,response to radiotherapy,length of hospital stay,radiotherapy cost,and 1-year prognosis were compared between the two groups.The functional assessment of cancer therapy-breast(FACT-B) scores of the two groups before treatment and 3 months after treatment were compared.Results There were no significant differences in cosmetic effects,when comparisons were made between the two groups(P>0.05).There were no grade 2 or higher radiotherapy reactions in the two groups during treatment,and there was no statistical significance in the rates of acute skin reaction,myelosuppression,radiation pneumonitis and esophageal mucosal reaction,when comparisons were made between the two groups(P>0.05).The length of hospital stay and radiotherapy cost in the large segmentation group were all lower than those in the conventional segmentation group(P<0.05).There were no significant differences in the scores of various FACT-B dimentions before and after treatment,when comparisons were made between the two groups(P>0.05).However,the scores of both groups after treatment were significantly higher than those before treatment(P<0.05).There were no significant differences in 1-year survival rate when comparisons were made between the two groups(P>0.05).Conclusion Hyperfractionation under IMRT could improve the quality of life,shorten the length of hospital stay and reduce the economic burden of breast cancer patients after breast-conserving surgery.