早期乳腺癌保乳术后调强放疗临床研究分析

【作者】 杜向慧； 郑远达； 孙晓江； 裘国勤； 许亚萍； 陈建祥； 季永领；

【机构】 浙江省肿瘤医院；

【摘要】 目的分析和比较了本院应用调强IMRT和常规切线野治疗早期乳腺癌保乳术后的近期疗效和毒副反应。方法2006年6月—2009年3月本院应用IMRT技术和常规切线野技术治疗86例保乳术后的早期乳腺癌患者,其中应用IMRT43例,常规切线野43例。全部病例均经手术病理证实。IMRT组患者的中位年龄为46(24～65)岁,常规切线野组中位年龄48岁(26-67岁)。所有患者均接受200cGy/次的常规分割照射,处方剂量为5000cGy,瘤床加量1000CGy/5次。结果所有患者均完成了预期的放疗计划。中位随访时间为13个月(2～30月)。所有患者均生存,至随访截止日无复发病例。IMRT中的V105%和V110%和常规治疗计划相比分别下降了10.1%和12.67%。按照RTOG放疗毒副反应评价标准,常规放疗组Ⅰ度、Ⅱ度的急性皮肤反应7例,出现Ⅲ度放射性皮肤反应3例。IMRT放疗组Ⅰ度、Ⅱ度的急性皮肤反应4例,出现Ⅲ度放射性皮肤反应1例。骨髓抑制情况两组相仿。结论与常规切线野放疗相比,乳腺IMRT放疗技术能使乳房靶区内剂量分布更均匀,急性皮肤毒性反应尤其是湿性皮炎的发生率进一步降低,从而进一步提高了患者的生活质量,改善乳房远期的美容效果。更多还原

【Abstract】 Objective To analyze short term outcomes and toxicities of the patients with breast cancer who were treated with intensity modulated radiation therapy(IMRT)and standar wedged technique. Methods 86 patients with breast cancer received IMRT and standard wedged technique between June 2006 and March 2009 in our hospital.Median age was 46 years(range 26-67 years).All patients received radiotherapy,The fraction size of radiotherapy was 200cGy/fx and the total dose was 5000cGy.RTOG radiation toxicity criteria was used in toxicity evaluation. Results All patients completed treatment.Median follow up was 13 months(range 2-30 months).All patients are survival.There was 7 standard radiation patients developed grade 1 and 2 acute skin toxicity(% ) 3 patients had grade 3 radiation skin toxicity(%).IMRT patients developed grade land 2 acute skin toxicity was 4(%),only 1 patient developed grade 3 acute skin toxicity. Conclusion Breast IMRT significantly improved the dose distribution compared with standard radiation. Breast IMRT would reduce the rate of acute skin reaction,decrease pain,and improve quality of life compared with standard radiotherapy using wedges.更多还原