摘要
目的 探讨早期乳腺癌根治术后或改良根治术后不同剂量分割放射方案的疗效。方法36 7例早期乳腺癌根治术后放疗患者 ,根据术后放射治疗的不同剂量分割方案分为 3组 :常规分割组14 9例 ,2Gy 次 ,每日 1次 ,每周 5次 ,总DT5 0Gy ;隔日照射组 177例 ,3Gy 次 ,每周 3次 ,总DT4 5Gy ;快速照射组 4 1例 ,第 1天和第 3天DT5Gy 次 ,第 15天和第 17天DT6 .5Gy 次 ,总DT2 3Gy。共有 2 5 7例接受了化疗和 (或 )内分泌治疗。结果 全组 5年总生存率和无病生存率分别为 87.4 %和 89.6 %。常规分割组、隔日照射组和快速照射组的 5年无病生存率分别为 90 .8%、86 .5 %和 84 .6 % (P =0 .16 ) ;局部区域复发率分别为 2 .7%、2 .8%和 2 .4 % ,差异无显著性。结论 隔日照射可取得和常规分割照射同样的疗效 ;快速照射缩短了疗程时间 ,其疗效和毒副作用值得进一步研究。
Objective To study the effect of post mastectomy radiotherapy with different fractionated dose schemes for early breast cancer. Methods From January 1987 to January 1993, 367 patients with early breast cancer were given post mastectomy radiotherapy with three different fractionatied dose schemes. 149 patients received conventional radiotherapy with 50 Gy/25 fractions/5 weeks (Group A). 177 patients received 45 Gy/15 fractions / 5 weeks (Group B). Forty one patients were treated with 23 Gy/4 fractions/17days (Group C). 257 patients received systemic therapy (chemotherapy and/or endocrine therapy). Results The overall 5 year survival and 5 year disease free survival rates were 87.4 % and 89.6%. The 5 year disease free survival rate were 90.8% , 86.5% and 84.6% for A, B and C groups ( P =0.16). The corresponding loco regional failure rates were 2.7%, 2.8% and 2.4%, respectively. There was no statistically significant difference in the local control and efficacy of the three groups. Conclusion With similar 5 year tumor free survival rates by the conventional fractionation and hypofractionation, the scheme with 45 Gy/15 fractions/ 5 weeks has the advantage of giving less factions, which is suitable for a unit with limited radiation resources. The course of hypofractionation with 23 Gy/4 fractions/17 days is much shorter than conventional radiotherapy, which may benefit patients with higher risk of metastasis who need to undergo chemotherpay earlier. This study warrants further investigations. [
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2003年第3期285-288,共4页
Chinese Journal of Oncology
