摘要
目的研究不同放疗技术用于乳腺癌根治术后的疗效及对患者预后的影响。方法回顾性分析126例已行乳腺癌根治术且需要术后放疗患者的临床资料,根据放疗技术进行分组,其中采用混合调强放疗(Hybrid Intensity-modulated radiation therapy,Hy-IMRT)的64例患者为观察组,采用三维适形放疗(3D-conformal radiotherapy,3D-CRT)的62例患者为对照组。观察2组放疗后靶区剂量学指标、器官剂量学及不良反应,放疗前、后细胞因子及T细胞亚群,2组患者放射治疗预后。结果放疗后观察组D_(95%)大于对照组(P<0.05),V_(105%)和V_(110%)明显低于对照组(P<0.05);而观察组CI更接近1,适形度更好(P<0.05);观察组HI低于对照组,其靶区内剂量更均匀(P<0.05)。观察组放疗后器官剂量低于对照组(P<0.05)。观察组放疗后骨髓抑制、放射性皮炎、消化障碍、白细胞下降、放射性肺损伤、放射性食管炎等不良反应发生率均低于对照组(P<0.05)。放疗后,2组IL-6、TNF-α、CD8^(+)高于放疗前(P<0.05),CD4^(+)、CD4^(+)/CD8^(+)低于放疗前(P<0.05),但观察组IL-6、TNF-α、CD8^(+)低于对照组(P<0.05),CD4^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05)。2组2年局部复发率、远处转移率及死亡率比较,差异无统计学意义(P>0.05)。结论Hy-IMRT对正常组织及器官损害较小,可减少不良反应发生及降低对免疫功能的影响,值得临床推广应用。
Objective To study the clinical effect and prognosis of different radiotherapy techniques on patients after radical mastectomy.Methods A retrospective analysis was done on the clinical data of 126 patients who had undergone radical mastectomy and required postoperative radiotherapy.According to different radiotherapy techniques,64 patients were included in the observation group with hybrid intensity-modulated radiation therapy(Hy-IMRT),and 62 patients were included in the control group with 3D-conformal radiotherapy(3D-CRT).The target area dosimetry index,organ metrology and side effects after radiotherapy,cytokines and T cell subsets before and after radiotherapy were observed,and the prognosis of the 2 groups of patients after radiotherapy was compared.Results After radiotherapy,D_(95%) of the observation group was greater than that of the control group(P<0.05).V_(105%)and V_(110%)were significantly lower than those of the control group(P<0.05),while the CI of the observation group was closer to 1,and the conformity was better(P<0.05).The HI of the observation group was lower than that of the control group,and the measurement in the target area was more even(P<0.05).The organ dose of the observation group after radiotherapy was lower than that of the control group(P<0.05).The incidence of adverse reactions such as bone marrow suppression,radiation dermatitis,digestive disorder,leukopenia,radiation lung injury,radiation esophagitis,etc.in the observation group after radiotherapy were lower than those in the control group(P<0.05).After radiotherapy,IL-6,TNF-α,CD8^(+) in the 2 groups were higher than those before radiotherapy(P<0.05),and CD4^(+),CD4^(+)/CD8^(+) were lower than those before radiotherapy(P<0.05).IL-6,TNF-α,CD8^(+) in the observation group were lower than those in the control group(P<0.05),whereas CD4^(+),CD4^(+)/CD8^(+) were higher than those in the control group(P<0.05).There was no significant difference in the 2-year local recurrence rate,distant metastasis rate and mortality between the 2 grou
作者
荀雷
陈红
史珂
XUN Lei;CHEN Hong;SHI Ke(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,471000)
出处
《实用癌症杂志》
2022年第9期1537-1540,1548,共5页
The Practical Journal of Cancer
关键词
放疗
乳腺癌
不良反应
预后
Radiotherapy
Breast cancer
Adverse reaction
Prognosis
