乳腺癌保乳术后全乳放疗瘤床同步补量与序贯瘤床补量的临床效果及剂量学对比

doi:10.20047/j.issn1673-7210.2023.17.26

Abstract
Figure/Table
References (29)
Related Citation (15)

Download: PDF (542 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To study the clinical effect and dosimetry comparison between synchronous supplement of tumor bed in whole breast and sequential tumor bed supplementation in whole breast radiotherapy after breast conserving surgery for breast cancer. Methods Seventy-four patients with breast cancer in Department of Radiotherapy, Fuyang Tumor Hospital from January 2017 to April 2021 were selected and treated with breast conserving surgery for breast cancer. After surgery, they were divided into sequential group and synchronous group according to the random number table method, with 37 cases in each group. The sequential group received sequential tumor bed complementary radiotherapy, and the synchronous group received synchronous tumor bed complementary radiotherapy. The clinical effects, target dose of tumor bed dose, radiation dose endangering organs, and adverse radiation reactions were compared between the two groups. Results There was no significant difference in clinical effect between the two groups (P＞0.05). The average dose and maximum dose of tumor bed addition planned target area in synchronous group were lower than those in sequential group, and the differences were statistically significant (P＜0.05). The maximum doses of heart V30, lung V20, and spinal cord in the synchronous group were lower than those in the sequential group, and the differences were statistically significant (P＜0.05). The incidence of radiation pneumonia in the synchronous group was lower than that in the sequential group, and the difference was statistically significant (P＜0.05). Conclusion Compared with sequential tumor bed complementary radiotherapy, synchronous tumor bed complementary radiotherapy after breast conserving surgery for breast cancer can reduce the target dose, reduce the damage to the heart, lung, spinal cord, and other dangerous organs, and reduce the incidence of adverse radiation reactions.

Key words： Breast conserving surgery for breast cancer Synchronous supplement of tumor bed in whole breast radiotherapy Sequential tumor bed complementary radiotherapy Clinical effect Dosimetry

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LU Feng ZHANG Fei LI Taiping

Cite this article:

LU Feng ZHANG Fei LI Taiping. Comparison of clinical effect and dosimetry between synchronous and sequential tumor bed complementary radiotherapy after breast conserving surgery for breast cancer[J]. 中国医药导报, 2023, 20(17): 115-118.

URL:

https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.17.26 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I17/115

[1] Tsang JYS，Tse GM. Molecular Classification of Breast Can- cer [J]. Adv Anat Pathol，2020，27（1）：27-35.
[2] Thorat MA，Balasubramanian R. Breast cancer prevention in high-risk women [J]. Best Pract Res Clin Obstet Gynaecol，2020，12（65）：18-31.
[3] Nanda A，Hu J，Hodgkinson S，et al. Oncoplastic breast- conserving surgery for women with primary breast cancer [J]. Cochrane Database Syst Rev，2021，10（10）：CD013658.
[4] Kaufman CS. Increasing Role of Oncoplastic Surgery for Breast Cancer [J]. Curr Oncol Rep，2019，21（12）：111.
[5] 李锋，王国辉，常晓静，等.高级别脑胶质瘤术后同步加量与序贯加量调强放疗疗效比较[J].中华放射肿瘤学杂志，2022，31（6）：513-518.
[6] 李恩萍，史天云，王博，等.瘤床同步加量调强放疗与序贯瘤床加量调强放疗治疗乳腺癌的临床效果观察[J].癌症进展，2020，18（21）：2209-2212.
[7] 徐敏，王素贞，王玮，等.早期乳腺癌保乳术后瘤床同步整合与瘤床后程补量IMRT研究[J].中华放射肿瘤学杂志，2020，29（11）：948-953.
[8] 中国抗癌协会乳腺癌专业委员会.中国抗癌协会乳腺癌诊治指南与规范（2019年版）[J].中国癌症杂志，2019，29（8）：609-679.
[9] 乐杰.妇产科学（第7版）[M].北京：人民卫生出版社，2018：334.
[10] 中华医学会医学美容与美学分会皮肤美容学组.放射性皮炎诊疗专家共识[J].中华医学美学美容杂志，2021， 27（5）：353-357.
[11] 中国肿瘤科相关专家小组.放射性肺损伤的诊断及治疗（共识）[J].中华放射肿瘤学杂志，2015，24（1）：4-9.
[12] Xu X，Zhang M，Xu F，et al. Wnt signaling in breast cancer：biological mechanisms，challenges and opportunities [J]. Mol Cancer，2020，19（1）：165.
[13] 章倩，方晓燕，刘娟，等.早期左侧乳腺癌保乳术后大分割放疗同期瘤床加量的安全性及心脏亚结构剂量评估的重要性研究[J].中国癌症杂志，2022，32（5）：427-435.
[14] 袁美芳，文晓博，刘梦岚，等.左乳癌保乳术后瘤床同步推量断层螺旋照射与断层定角照射的放疗剂量学研究[J].实用临床医药杂志，2021，25（1）：6-9.
[15] 王升晔，杜向慧，封巍，等.早期乳腺癌保乳术后全乳大分割照射同步瘤床加量与常规分割放疗的效果对比[J].中华全科医学，2019，17（8）：1292-1295.
[16] 王宋，邓建，吕红英，等.基于SEER数据库分析保乳术和乳房切除术对不同淋巴结转移状况的T1期三阴性乳腺癌预后的影响[J].中国临床研究，2021，34（8）：1014- 1018.
[17] 刘军，陈成玲，李昌文，等.奥拉帕利辅助治疗对乳腺癌非保乳手术术后病理阳性患者预后、腋窝局部复发和远处复发的影响[J].临床和实验医学杂志，2023，22（6）：628-632.
[18] 吉维，刘梦岚，文晓博，等.左侧乳腺癌保乳术后瘤床同步推量螺旋断层放疗与容积调强放疗的剂量学研究[J].国际肿瘤学杂志，2021，48（9）：532-536.
[19] 赵兵，李云海，肖锋，等.肺癌脑转移瘤同期加量调强放疗与序贯加量放疗的对比研究[J].肿瘤学杂志，2020， 26（9）：808-812.
[20] 岳丹，杨永净，赵玲，等.早期乳腺癌保乳术后加速部分乳腺照射对比全乳腺照射瘤床推量照射的临床研究[J].中华放射医学与防护杂志，2018，38（9）：664-669.
[21] 马家宝，范羽，许敬辉，等.早期乳腺癌保乳术后低分割瘤床同步加量放疗方法的前瞻性临床研究[J].中华放射医学与防护杂志，2018，38（7）：505-509.
[22] 曾琴.早期乳腺癌保乳术后同步和序贯瘤床补量放疗的比较[D].泸州：西南医科大学，2020.
[23] 岳丹，白燕，李新迪，等.早期乳腺癌保乳术后加速部分乳腺调强放疗与全乳腺同步推量调强放疗的剂量学比较[J].肿瘤研究与临床，2020，32（8）：546-551.
[24] 王升晔，杜向慧，封巍，等.早期乳腺癌保乳术后全乳大分割照射同步瘤床加量与常规分割放疗的效果对比[J].中华全科医学，2019，17（8）：1292-1295.
[25] 文晓博，赵彪，吉维，等.左乳癌保乳术后瘤床同步推量sIMRT与HT剂量学研究[J].西部医学，2021，33（9）：1332-1335.
[26] 张成.早期乳腺癌CT诊断以及保乳术后瘤床同步加量短疗程放疗临床观察[J].中国医疗设备，2018，33（A02）：2.
[27] 王嘉颖，陶振洲，张树琦，等.乳腺癌保乳手术后放疗的研究进展[J].中国医药，2021，16（10）：1589-1592.
[28] 龙向瑜，胡海北，陈强，等.TC方案联合保乳术与改良根治术对乳腺癌患者的临床效果及对乳房美容、心理状态的影响[J].中国医药科学，2022，12（2）：136-139.
[29] 刘小龙，杨波，庞皓文，等.左侧乳腺癌保乳术后瘤床X射线同步推量与后程电子线补量调强放射治疗剂量学比较[J].中国医学装备，2020，17（6）：15-18.