延迟放疗对乳腺癌保乳术后患者生存状况影响的研究

目的 探讨延迟放疗对乳腺癌保乳手术后患者生存状况的影响.方法 选取乳腺癌保乳手术患者150例,按随机数表法将患者分为对照组和观察组,每组75例.两组患者行乳房保留术后,对照组行常规放疗后辅助化疗;观察组根据患者具体情况,先行辅助化疗,再行放疗,延迟＞8周.观察并统计两组患者的术后局部复发(LR)、总生存(OS)、不良反应情况.结果 术后3年,观察组及对照组LR率分别为20.00％ (15/75)和36.00％ (27/75),差异有统计学意义(x2 =4.631,P=0.031);观察组及对照组OS率分别为94.67％和86.67％,差异无统计学差异(x2=2.953,P=0.134).观察组并发症1例,为皮下积液,转移2例;对照组并发症6例,其中皮下积液6例.转移8例,两组比较具显著差异(P＜0.05);治疗后观察组和对照组角色功能、情绪功能、社会功能和躯体功能等各项生活质量评分分别为(81.3±3.4)、(69.1±4.8)、(80.5±5.1)、(79.5±6.1)和(70.3±2.6)、(55.9±3.3)、(60.2±4.1)、(65.1±5.8)分,两组各项比较差异显著,具统计学意义(P＜0.05);观察组美容效果优良率为97.33％,高于对照组86.67％,差异具有统计学意义(x2 =8.631,P=0.003).结论 延迟放疗能对乳腺癌保乳手术患者患者生存状况产生积极影响,预后效果较好,患者生活质量明显提高,值得临床推广.

Research of Delayed Radiotherapy on the Survival Status of Patients with Breast Cancer after Breast-conserving Surgery

Objective To investigate the effect of delayed radiotherapy on survival status of patients after breast conserving surgery.Methods 150 cases of patients treated with breast conserving surgery were selected and randomly divided into the control group and the observation group by random number table,75 cases in each group.Both groups received breast-conserving surgery,the control group underwent conventional radiotherapy and adjuvant chemotherapy;the observation group according to the specific circumstances,received radiotherapy after adjuvant chemotherapy,with delay ＞ 8 weeks.Postoperative local recurrence (LR),overall survival (OS) and adverse reactions of the 2 groups were observed.Results 3 years after surgery,postoperative LR rates of the observation group and the control group were 20.00％ (15/75) and 36.00％ (27/75),there had significant difference (P =0.031).OS rates of the observation group and the control group were 94.67％ and 86.67％,respectively,there was no statistically difference (P =0.134).;In the observation group,complications 1 case was subcutaneous effusion,metastasis in 2 cases,in the control group,6 cases of complications was subcutaneous effusion,metastasis in 8 cases,there had significant difference (P =0.003);After treatment,role function,emotional function,social function and physical function the observation group and the control group were (81.3-± 3.4)、(69.1 ± 4.8)、(80.5-± 5.1)、(79.5 ± 6.1) and(70.3 ± 2.6)、(55.9 ± 3.3)、(60.2 ± 4.1)、(65.1 ± 5.8),there was significant difference (P ＜ 0.05).Excellent cosmetic result of the observation group was 97.33％,which was higher than the control group,86.67％,the difference was statistically significant (P ＜ 0.05).Conclusion Delayed radiotherapy has positive impact on survival of patients treated with breast conserving surgery,the prognosis is better,the quality of life significantly improved,it is worthy of clinical promotion.