标题：早期乳腺癌保留乳房手术后全乳腺大分割与常规分割放疗的疗效和毒副反应比较

      作者：孟凡军，陈育标，庄梅生    (揭阳市人民医院放疗科，广东 揭阳 522000)

      卷次： 2017年28卷12期

      【摘要】 目的 比较早期乳腺癌保留乳房手术后全乳腺大分割放疗与常规分割放疗的近期疗效和毒副反应。方法 选择2010年1月至2013年10月我院放疗科收治的84例术后早期乳腺癌患者，根据随机数表法将患者随机分为观察组与对照组，每组42例，所有患者均接受保乳手术治疗，观察组术后予大分割放疗，全乳计划靶区为42.56 Gy/16f，疗程共25~27 d，对照组则予常规分割放疗，50 Gy/25f，疗程为6周。比较两组患者的不良反应、美容效果及随访生存情况。结果 观察组与对照组组患者1级急性皮肤反应、1级皮肤及皮下组织晚期反应、1级白细胞减少发生率及美容效果优良率分别为 57.14%、16.67%、11.90%、59.52%和 47.62%、7.14%、19.04%、64.29%，两组比较差异均无统计学意义(P>0.05)；随访3年时，两组患者的生存率均为100%，且均未出现局部复发。结论 保乳术后全乳腺大分割放射治疗可缩短疗程，具有确切的疗效，且并未增加不良反应发生率。
      【关键词】 乳腺癌；放射治疗；剂量；不良反应
      【中图分类号】 R737.9 【文献标识码】 A 【文章编号】 1003—6350（2017）12—2024—02

Comparison of efficacy and toxicity between whole breast hypofractionated radiotherapy and conventionalfractionated radiotherapy after breast conserving surgery for early breast cancer.
MENG Fan-jun, CHEN Yu-biao,ZHUANG Mei-sheng. Department of Radiotherapy, the People's Hospital of Jieyang City, Jieyang 522000, Guangdong, CHINA
【Abstract】 Objective To compare the efficacy and toxicity between whole breast hypofractionated radiotherapyand conventional fractionated radiotherapy after breast conserving surgery for early breast cancer. Methods A total of 84cases of early breast cancer patients, who admitted to Department of Radiotherapy of our hospital from January 2010 toOctober 2013 were selected and randomly divided into the two groups according to random number table, with 42 cases ineach group. All the patients underwent breast conserving surgery. Then the observation group were given whole breast hy-pofractionated radiotherapy with whole breast plan target area of 42.56 Gy/16 f for 25-27 d, while the control group wastreated with conventional fractionated radiotherapy with whole breast plan target area of 50 Gy/25 f for six weeks. The ad-verse effects, cosmetic effects and follow-up survival of the two groups were compared. Results The grade 1 acute skinreactions and grade 1 of skin and subcutaneous tissue late reaction, grade 1 white cell (WBC) reduction rate and cosmeticexcellent rate were respectively 57.14%, 16.67%, 11.90%, 59.52% in the observation group and 47.62%, 7.14%, 19.04%,64.29% in the control group, with no significant differences between the two groups (P>0.05). At 3 years of follow-up, thesurvival rates of the two groups were 100%, and there was no local recurrence. Conclusion Whole breast hypofractionat-ed radiotherapy after breast conserving surgery can shorten the course of treatment with the exact effect, and which doesnot increase the incidence of adverse effects.
      【Key words】 Breast cancer; Radiotherapy; Dose; Adverse effect·临床经验·doi:10.3969/j.issn.1003-6350.2017.12.044