摘要
目的探讨瘤床同步加量调强放疗(simultaneous integrated boost intensity-modulated radiation therapy, SIB-IMRT)对乳腺癌保乳术后患者肿瘤标志物、生存质量的影响。方法以成都市第三人民医院2015年6月至2018年6月收治的乳腺癌保乳术后患者为研究对象, 选择其中常规放射治疗(conventional radiotherapy, CRT)的55例患者纳入对照组, 选取同期SIB-IMRT的患者49例纳入观察组。收集两组患者的放疗时间、放疗相关不良反应;放疗前及放疗后6个月时两组患者血清肿瘤标志物[β2微球蛋白(β2-microglobulin, β2-MG)、糖类抗原125(carbohydrate antigen 125, CA125)、组织多肽特异性抗原(tissue polypeptide specific antigen, TPS)、糖类抗原153(carbohydrate antigen 153, CA153)]的变化;放疗后6个月时近期实体瘤治疗效果;随访两组患者5年生存质量[无进展生存期(progression-free survival, PFS)、总生存时间(overall survival, OS)]。呈正态分布的计量资料以xˉ±s表示, 采用t检验;计数资料采用χ^(2)检验或Fisher检验;等级资料组间比较采用非参数秩和检验。结果观察组患者放疗时间短于对照组[(37.46±6.74)d与(43.63±7.26)d], 观察组放疗相关不良反应发生率低于对照组[14.29%(7/49)与32.73%(18/55)], 组间比较差异均有统计学意义(统计量值分别为4.47、4.83, P值分别为<0.001、0.028)。放疗前, 两组患者血清β2-MG、CA125、TPS、CA153水平比较差异均无统计学意义(均P>0.05);放疗后6个月, 观察组β2-MG、CA125、TPS、CA153均低于对照组[β2-MG:(1.25±0.21)mg/L与(1.86±0.37)mg/L, CA125:(15.17±2.56)kU/L与(18.81±3.13)kU/L, TPS:(9.43±1.58)μg/L与(13.49±2.51)μg/L, CA153:(11.75±1.63)kU/L与(15.46±3.07)kU/L], 组间比较差异均有统计学意义(t值分别为10.17、6.44、9.73、7.56, 均P<0.01)。放疗后6个月, 两组患者疾病控制率比较差异无统计学意义(P>0.05);观察组客观缓解率高于对照组[53.06%(26/49)与32.73%(18/55)], 差异有统计学
ObjectiveTo explore the influence of simultaneous integrated boost intensity-modulated radiation therapy(SIB-IMRT)on tumor markers and quality of life after breast-conserving surgery for breast cancer.MethodsPatients after breast-conserving surgery for breast cancer in the Third People's Hospital of Chengdu were selected from June 2015 to June 2018 as the study subjects.Fifty-five cases with conventional radiotherapy(CRT)were selected and included in control group,and 49 cases with SIB-IMRT were enrolled as observation group.The radiotherapy time and radiotherapy-related adverse reactions,serum tumor markers(β2-microglobulin(β2-MG),carbohydrate antigen 125(CA125),tissue polypeptide specific antigen(TPS),carbohydrate antigen 153(CA153))before radiotherapy and at 6 months after radiotherapy,short-term solid tumor treatment effect at 6 months after radiotherapy and quality of life(progression-free survival(PFS),overall survival(OS))after 5 years of follow-up were collected in both groups of patients.Measurement data were presented as x¯±s by t test.Enumeration data were analyzed byχ^(2) test or Fisher test.Nonparametric rank sum test was used to compare the distribution of ranked data between groups.ResultsThe radiotherapy time in observation group was shorter than that in control group((37.46±6.74)d vs(43.63±7.26)d),and the incidence of radiotherapy-related adverse reactions was lower than that in control group(14.29%(7/49)vs 32.73%(18/55))(Statistical values were 4.47 and 4.83,P values were<0.001 and 0.028).At 6 months after radiotherapy,the levels ofβ2-MG,CA125,TPS and CA153 in observation group were lower compared to control group((1.25±0.21)mg/L vs(1.86±0.37)mg/L,(15.17±2.56)kU/L vs(18.81±3.13)kU/L,(9.43±1.58)μg/L vs(13.49±2.51)μg/L,(11.75±1.63)kU/L vs(15.46±3.07)kU/L)(t=10.17,6.44,9.73,7.56;all P<0.01),but there was no statistical significance in disease control rate between the two groups(P>0.05).The observation group had higher objective remission rate(53.06%(26/49)vs 32.73%(18/55)),and the
作者
冉杰
蒋莎莎
袁梦珍
荣丽雯
赖琼
张军
Ran Jie;Jiang Shasha;Yuan Mengzhen;Rong Liwen;Lai Qiong;Zhang Jun(Department 2 of Oncology,The Third People's Hospital of Chengdu,Sichuan Province,Chengdu 610031,China)
出处
《中国综合临床》
2024年第6期401-408,共8页
Clinical Medicine of China
基金
成都市科技项目(2022-YF05-02119-SN)。
关键词
乳腺癌
保乳术
瘤床同步加量调强放疗
肿瘤标志物
生存质量
Breast cancer
Breast-conserving surgery
Simultaneous integrated boost intensity-modulated radiation therapy
Tumor markers
Quality of life
