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Received:January 11, 2022 Published Online:September 20, 2022
Received:January 11, 2022 Published Online:September 20, 2022
中文摘要: 目的 探讨乳腺癌改良根治术后大分割与常规分割调强放疗后的短期疗效和相关不良反应。方法 选择2020年9月至12月河北工程大学附属医院收治的124例乳腺癌改良根治术后放疗患者进行前瞻性研究，其中29例为二步法乳房重建术后患者。根据患者意愿，将74例分至大分割放疗组（二步法重建患者18例），50例分至常规分割放疗组（二步法重建患者11例）。从放疗开始至结束后第1、7、13个月对患者进行随访，对比分析两组的短期疗效和近、远期不良反应。结果 两组总生存率均为100%，局部复发率差异无统计学意义（P>0.05）。两组放疗不良反应，如皮肤反应、食管黏膜反应、骨髓抑制、放射性肺损伤、放射性心脏损伤、上肢损伤、切口不适等差异无统计学意义（P>0.05），但在大分割放疗组疲乏感的发生率更低（P＜0.05）。重建相关放疗并发症中，包膜挛缩、切口异常、舒适度、美容效果等差异无统计学意义（P>0.05），大分割组乳房重建失败率较常规分割组有所降低,但差异无统计学意义（P=0.054）。结论 乳腺癌改良根治术后应用大分割和常规分割两种放疗疗法的近期疗效及不良反应相似。大分割放疗可减缓患者疲乏感，有降低乳房重建失败率的趋势。
Abstract:Objective To investigate the short-term efficacy and related adverse reactions of hypofractionated and conventional fractionated intensity-modulated radiotherapy after modified radical mastectomy for breast cancer. Methods A prospective study was conducted on 124 patients with breast cancer treated in the Affiliated Hospital of Hebei University of Engineering from September to December 2020, including 29 patients after two-step breast reconstruction. According to the wishes of patients, 74 patients were divided into hypofractionated radiotherapy group (18 patients with two-step reconstruction) and 50 patients into conventonal fractionated radiotherapy group (11 patients with two-step reconstruction). The patients were followed up from the beginning of radiotherapy to the 1st, 7th and 13th month after radiotherapy. The short-term efficacy and short-term and long-term adverse reactions of the two groups were compared and analyzed. Results The overall survival rate of the two groups was 100%, and no significant difference was found in local recurrence rate (P>0.05). There was no significant difference in the adverse reactions of radiotherapy (such as skin reaction, esophageal mucosal reaction, bone marrow suppression, radioactive lung injury, radioactive heart injury, upper limb injury, incision discomfort, etc.) between two groups (P>0.05), but the incidence of fatigue was lower in the hypofractionated radiotherapy group (P<0.05). There was no significant difference in capsule contracture, abnormal incision, comfort and cosmetic effect among reconstruction related radiotherapy complications (P>0.05). The failure rate of breast reconstruction in the hypofractionated radiotherapy group group was lower than that in the conventional fractionated radiotherapy group, but the difference was not statistically significant(P=0.054). Conclusion The short-term efficacy and adverse effects of hypofractionated radiotherapy and conventionally fractionated radiotherapy after modified radical mastectomy for breast cancer were similar. Hypofractionated radiotherapy can reduce the fatigue of patients, and has a tendency to reduce the failure rate of breast reconstruction.
keywords: Breast cancer Conventional fractionated radiotherapy Hypofractionated radiotherapy Modified radical mastectomy for breast cancer Breast reconstruction Adverse reaction Short-term
文章编号： 中图分类号：R737.9 文献标志码：A
基金项目:吴阶平基金会临床科研专项资助基金(320.6750.2021-02-65)；邯郸市科学技术研究与发展计划项目(21422083353)
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