乳腺癌改良根治术后大分割放疗与常规分割放疗毒性比较

Conventional Segment Radiotherapy after Modified Radical Mastectomy for Breast Cancer

目的:探讨常规分割放疗与大分割放疗应用于乳腺癌改良根治术后的不良反应情况。方法:选取60例在本院行乳腺癌改良根治术的患者,入院时间为2016年1月-2017年12月期间,按照随机数字表法分为对照组与观察组,每组各30例。对照组采取常规分割放疗,观察组采取大分割放疗,对患者随访12个月,观察比较两组患者的近期疗效及毒性反应。结果:对患者均随访12个月,两组局部复发率、远地转移率、12个月生存率比较,差异均无统计学意义(P>0.05)。本组患者急性皮肤反应(1～2级放射性损伤)有16例,声嘶10例,放疗引起白细胞减少等血液毒性反应4例,超过半年以上的晚期损伤,包括2级以上放射性肺损伤、皮肤溃疡形成、臂丛损伤等两组患者均未出现,仅有5例患者复查胸部CT提示肺部炎症性改变较前增多,两组急性和晚期损伤比较差异均无统计学意义(P>0.05)。结论:大分割放射治疗的短期生存率及局部复发率与常规分割放射治疗相当,两者放疗后毒副作用比较无明显差异,可考虑替代常规分割放疗在临床上推广。

Objective:To investigate the adverse reactions of conventional and macroscopic fractionation radiotherapy after modified radical mastectomy for breast cancer.Method:60 cases with breast cancer modified radical in our hospital from January 2016 to December 2017 were selected,they were divided into two groups according the randomly number table,30 cases in each group.The control group adopt standard segmentation radiation,the observation group was given big radiation therapy.The patients were followed up for 12 months,the recent curative effect and toxic effects were observed and compared.Result:All patients were followed up for 12 months,and there were no significant differences between the two groups in terms of local recurrence and distant metastasis(P>0.05),and there was no significant difference in the12-month survival rate between the two groups(P>0.05).The patients with acute skin reaction(1-2 levels of radioactive damage)in 16 cases,10 cases of hearing,radiotherapy leukopenia caused by blood toxicity reaction in 4 cases,more than half a year late damage,including more than 2 level of radioactive lung injury,skin ulceration,brachial plexus injury such as two groups of patients did not appear,only five were prompt review of chest CT in patients with pulmonary inflammatory change from the previous increase,acute and late injury compared the two groups have no obvious difference(P>0.05).Conclusion:Divided radiotherapy short-term survival rate and local recurrence rate and conventional radiotherapy,segmentation both side effects after treatment was no significant difference,can consider to replace the conventional segmentation radiation therapy in clinical promotion.