早期乳腺癌保乳术后图像引导放射治疗的临床价值

目的探讨早期乳腺癌保乳术后图像引导放射(IGRT)治疗的临床价值。方法选取2013年1月至2013年10月间确诊为早期乳腺癌并接受保乳术的患者60例。按照随机数字表法将60例患者分为调强放疗(IMRT)组和IGRT组,每组30例。评价两组靶区及正常组织所受照射剂量、急性毒性反应及乳房美容效果方面的差异。结果 IGRT组的适形指数(CI)和均匀指数(HI)均优于IMRT组,差异均有统计学意义(均P<0.05)。IGRT组正常组织所受照射剂量均低于IMRT组,差异有统计学意义(P<0.05)。两组皮肤毒性反应比较,差异无统计学意义(P>0.05),无Ⅱ^Ⅲ度急性皮肤毒性反应。放射治疗6个月后,两组患者乳房美容效果优良率均为100%。结论 IMRT和IGRT对早期乳腺癌保乳术后法放射治疗效果均较好,但IGRT具有更高的放射治疗精准度,能更好地减少正常组织的照射剂量,具有较高的临床应用价值。

Clinical values of image guided radiation therapy for early breast conserving surgery

Objective To investigate the value of image guided radiation therapy（IGRT） for early breast conserving surgery.Methods Sixty cases of patients diagnosed as early stage breast cancer and receive breast-conserving surgery in the affiliated tumor hospital of Xinjiang medical university from January2013 to October 2013 were chosen for the study.According to a random number table,60 patients were divided into intensity-modulated radiotherapy（IMRT） group and IGRT groups.The radiation dose of normal tissue and target groups,the acute toxicity and the breast cosmetic between the two groups were compared.Results The homogeneity idex and conformity index of the IGRT group were both better than those of the IMRT group（P 〈 0.05）.The radiation dose of normal tissue of the IGRT group were lower than those of the IMRT group（P 〈 0.05）.There was no statistically significant difference between the two groups（P 〈0.05） and no Ⅱ ~ Ⅲ severe acute skin toxicity was found.After six months’ of radiation therapy,breast cosmetic excellent rate of the two groups were both 100%.Conclusion The effect of IMRT and IGRT for the treatment of early breast conserving surgery are both good,while the IGRT radiation therapy is with higher precision,can better reduce the radiation dose for normal tissues,which has a high clinical value.