大分割放疗同步瘤床加量治疗早期乳腺癌保乳手术后患者的疗效及安全性

Efficacy and safety of simultaneous integrated boost in hypofractionated radiotherapy for early breast cancer patients after breast-conserving surgery

目的:观察大分割放疗同步瘤床加量治疗早期乳腺癌保乳术后患者的疗效及不良反应。方法:收集唐山市人民医院2018年05月至2022年04月收治的早期乳腺癌保乳术后患者的临床资料,依据放疗方式分为大分割放疗同步瘤床加量组(观察组)和大分割放疗序贯瘤床加量组(对照组),分析两组患者局部复发和远处转移情况、放疗期间及放疗结束后不良反应(包括急性皮肤反应、放射性肺炎及骨髓抑制)、美容效果、治疗天数,两组年龄采用t检验,两组的其余临床基线特征、不良反应及疗效应用χ^(2)检验。结果:中位随访36个月。观察组与对照组的3年局部复发率(0.8%和0)与远处转移率(1.7%和0.7%)差异无统计学意义(P>0.05)。观察组与对照组患者不良反应均以Ⅰ级及Ⅱ级为主,放疗时急性皮肤反应、骨髓抑制、放射性肺炎发生情况以及放疗结束后美容效果方面差异均无统计学意义(P>0.05)。观察组患者治疗天数[(21.79±0.87)天]少于对照组[(24.55±1.16)天],差异有统计学意义(P=0.000)。结论:大分割放疗同步瘤床加量治疗早期乳腺癌保乳术后患者的疗效确切,且未增加不良反应,具有良好的美容效果,同时可以缩短治疗时间,节约医疗资源,减轻患者经济负担。

Objective:To observe the efficacy and adverse effects of simultaneous integrated boost in hypofractionated radiotherapy for early breast cancer patients after breast-conserving surgery.Methods:Clinical data of patients with early breast cancer after breast-conserving surgery from May 2018 to April 2022 were collected.According to radiotherapy scheme,these patients were divided into groups between simultaneous integrated boost(observation group) and sequential boost(control group).The analyzed local relapse rate and distant metastasisrate of patients,the adverse effects during and after radiotherapy(including acute skin reaction,radiation pneumonia and bone marrow suppression),cosmetic effect,treatment days were analyzed.t-test analyzed the age of the two groups,and χ~2 test analyzed the remaining clinical baseline characteristics,adverse effects and efficacy.Results:A median follow-up was 36 months.There was no significant difference in 3-year local recurrence rate(0.8% and 0) and distant metastasis rate(1.7% and 0.7%) between observation group and control group(P>0.05).The adverse effects between observation group and control group were mainly grade Ⅰ or Ⅱ,and there were no significant differences in acute skin reaction,bone marrow suppression,radiation pneumonia and cosmetic effect after radiotherapy(P>0.05).Treatment days in the observation group were shorter than those in the control group(21.79±0.87 days versus 24.55±1.16 days),and the difference was statistically significant(P=0.000).Conclusion:The clinical efficacy of simultaneous integrated boost in hypofractionated radiotherapy is exact for early breast cancer patients after breast-conserving surgery,and the adverse effects are not increased,with good cosmetic effect,at the same time the simultaneous integrated boost in hypofractionated radiotherapy can shorten the treatment time,save medical resources and reduce the economic burden of patients.