瘤床同步推量在早期乳腺癌保乳术后大分割放疗与常规分割放疗中的应用

Application of simultaneous integrated boost in hypofractionated radiotherapy and conventionally fractionated radiotherapy for early breast cancer after breast conserving surgery

目的比较瘤床同步推量(SIB)技术在早期乳腺癌保乳术后大分割放疗与常规分割放疗中的应用。方法将126例早期乳腺癌保乳术后患者按分割方式的不同分为大分割组67例和常规分割组59例。大分割组全乳照射40.5 Gy/15 f,21天,SIB 48 Gy/15 f,21天;常规分割组全乳照射50 Gy/25 f,35天,SIB 60 Gy/25 f,35天。比较两组患者靶区及周围危及器官受照射剂量、急性不良反应及局部控制率。结果常规分割组中位随访34个月,大分割组中位随访16个月。两组患者各危及器官受照射剂量、2年局部复发率、各不良反应发生率比较,差异均无统计学意义(P﹥0.05)。结论乳腺癌保乳术后大分割放疗的近期疗效和不良反应与常规分割放疗相似,且能缩短治疗时间,可应用于临床实践。

Objective To compare the application of simultaneous integrated boost(SIB)technique in hypofractionated radiotherapy and conventionally fractionated radiotherapy for early breast cancer after breast conserving surgery.Method A total of 126 patients with early breast cancer after breast conserving surgery were divided into hypofractionated group(67 cases)and conventionally fractionated group(59 cases).In the hypofractionated group,whole breast irradiation was 40.5 Gy/15 f for 21 days and SIB was 48 Gy/15 f for 21 days.In the conventionally fractionated group,whole breast irradiation was 50 Gy/25 f for 35 days and SIB was 60 Gy/25 f for 35 days.The radiation dose of target area and surrounding organs at risk,acute adverse reactions and local control rate were compared between the two groups.Result The median follow-up was 34 months in the conventionally fractionated group and 16 months in the hypofractionated group.There were no significant differences in radiation dose of organs at risk,local recurrence rate in 2 years and incidence of adverse reactions between the two groups(P>0.05).Conclusion The short-term efficacy and adverse reactions of hypofractionated radiotherapy after breast conserving surgery are similar to those of conventionally fractionated radiotherapy,and can shorten the treatment time,so it can be used in clinical practice.