浅析调强放射治疗对乳腺癌保乳术后患者的影响

Influence of intensity-modulated radiation therapy on patients with breast cancer after breast-conserving surgery

目的 探讨调强放射治疗对乳腺癌保乳术后患者的影响。方法 选取2015年3月—2019年10月在本院接受保乳术治疗的98例乳腺癌患者作为研究对象,按随机数字表法分为观察组与对照组,每组各49例。对照组采用常规放射治疗,观察组采用调强放射治疗。比较2组疗效、计划靶区剂量学、肌钙蛋白水平、预后情况。结果观察组疗效总有效率为83.67%,高于对照组的65.31%,差异具有统计学意义(χ^(2)=4.350,P=0.037);观察组计划靶区V100%、V105%分别为(9.68±0.65)%、(1.03±0.06)%,分别低于对照组的(42.02±4.87)%、(24.51±2.54)%,差异具有统计学意义(t=46.076、64.691,P值均<0.001);放疗后,观察组和对照组肌钙蛋白分别为(0.116±0.012)ng/mL、(0.260±0.019)ng/mL,分别高于放疗前的(0.059±0.010)ng/mL、(0.057±0.009)ng/mL,差异具有统计学意义(P<0.05),但观察组肌钙蛋白较对照组低,差异有统计学意义(t=44.855,P<0.001);观察组的无瘤生存率为97.96%,高于对照组的83.67%,差异具有统计学意义(χ^(2)=4.405,P=0.036)。结论 对乳腺癌保乳术后患者辅以调强放射治疗,可提高临床疗效,调节靶区照射剂量均匀性、适应性,避免心肌及其他周围组织损伤,并提高无瘤生存率,改善预后。

Objective To investigate the effect of intensity-modulated radiation therapy (IMRT) on patients with breast cancer after breast-conserving surgery.Methods A total of 98 patients with breast cancer who underwent breastconserving surgery in our hospital from March 2015 to October 2019 were selected as the study subjects.They were divided into an observation group and a control group according to the random number table method,with 49 cases in each group.The control group was treated with conventional radiation therapy,and the observation group was treated with intensity modulated radiation therapy.The curative effect,planned target dosimetry,troponin level,and prognosis were compared between the two groups.ResultsThe total effective rate of the observation group was 83.67%,which was higher than that of the control group (65.31%),and the difference was statistically significant (χ^(2)=4.350,P=0.037).The V100% and V105%of the planned target area in the observation group were (9.68±0.65)%and (1.03±0.06)%respectively,which were lower than those in the control group:(42.02±4.87)%and (24.51±2.54)%respectively,and the differences were statistically significant (t=46.076,64.691,both P<0.001).After radiotherapy,the troponin in the observation group and the troponin in the control group were (0.116±0.012) ng/m and (0.260±0.019) ng/m,respectively,higher than those before radiotherapy:(0.059±0.010) ng/m and (0.057±0.009) ng/m,with statistically significant differences (both P<0.05),but the troponin in the observation group was lower than that in the control group,with statistically significant difference (t=44.855,P<0.001).The tumor-free survival rate of the observation group was 97.96%,which was higher than that of the control group:(83.67%),and the difference was statistically significant (χ^(2)=4.405,P=0.036).Conclusion IMRT for patients with breast cancer after breast-conserving surgery can improve the clinical efficacy,adjust the uniformity and adaptability of irradiation dose in the target area,avoid myocardial and other surrounding tissue damages,and improve the tumor-free survival rate and the prognosis.