调强放疗与三维适形放疗对乳腺癌术后病人的疗效比较

    Comparison of the therapeutic effects between IMRT and 3D-CRT in the treatment of postoperative breast cancer

    • 摘要:
      目的探究调强放疗(IMRT)与三维适形放疗(3D-CRT)对乳腺癌术后病人的治疗效果。
      方法选取122例乳腺癌术后病人为研究对象,采用随机数字表法分为IMRT组与3D-CRT组,各61例。比较2组术后1年复发转移情况,并比较2组美容效果及急性放射性皮肤损伤发生情况,以及放疗前及放疗5周后血清激素雌二醇(E2)、孕酮(P)和肿瘤标志物癌胚抗原(CEA)、糖类抗原153(CA153)的变化。
      结果术后1年,2组均未出现复发转移病例。IMRT组美容效果及优良率显著高于3D-CRT组(P < 0.05),急性放射性皮肤损伤发生率低于3D-CRT组(P < 0.05)。2组放疗前后血清E2和P水平差异无统计学意义(P>0.05)。放疗5周后,2组血清CA153和CEA水平均比放疗前下降(P < 0.01),组间差异无统计学意义(P>0.05)。
      结论IMRT及3D-CRT对乳腺癌术后放疗效果均较好,但IMRT在减少皮肤损伤、美容效果方面更具优势,于提升病人生活质量有积极意义。

       

      Abstract:
      ObjectiveTo compare the effects between intensity modulated radiotherapy(IMRT) and three-dimensional conformal radiotherapy(3D-CRT) in the treatment of postoperative breast cancer.
      MethodsOne hundred and twenty-two postoperative breast cancer patients were divided into the IMRT group and 3D-CRT group according to the random number table method(61 cases each group).The recurrence and metastasis after 1 year of operation were compared between two groups.The cosmetic effects and occurrence of acute radiation skin injury were compared between two groups.The levels of serum hormonesestradiol(E2) and progesterone(P) and tumor markerscarcinoembryonic antigen(CEA) and carbohydrate antigen 153(CA153) were compared between two groups before and after 5 weeks of radiotherapy.
      ResultsAfter 1 year of operation, no recurrence or metastasis case occurred in two groups.The excellent rate of cosmetic effects in IMRT group was significantly higher than that in 3D-CRT group, and the incidence rate of acute radiation skin injury in IMRT group was lower than that in 3D-CRT group(P < 0.05).There was no statistical significance in the serum levels of E2 and P in two groups between before and after radiotherapy(P>0.05).After 5 weeks of radiotherapy, the serum levels of CA153 and CEA in two groups were lower than those before radiotherapy(P < 0.05), but the difference of which was not statistically signficant between two groups(P>0.05).
      ConclusionsBoth IMRT and 3D-CRT have good effects on postoperative radiotherapy of breast cancer, but IMRT has more advantages in reducing skin damage and cosmetic effect, and positive significance in improving patients' quality of life.

       

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