乳腺癌改良根治术后调强放疗与常规放疗疗效及对心肺的影响

目的:探讨乳腺癌改良根治术后调强放疗与常规放疗的疗效及对心肺的影响。方法:选择乳腺癌改良根治术患者60例,按照不同放疗方法分为观察组30例与对照组30例。观察组患者行调强放疗,对照组患者行常规放疗。比较两组近期,放疗前后心肌酶肌钙蛋白和肺功能变化,以及患肺和心脏受照剂量变化。结果:两组近期总有效率比较无显著差异(P>0.05)。两组放疗后肌钙蛋白水平较放疗前升高(P<0.05);观察组放疗后肌钙蛋白水平低于对照组(P<0.05)。两组放疗后射血分数较放疗前降低,而LADs和LVDd较治疗前升高(P<0.05);观察组放疗后射血分数高于对照组,而LADs和LVDd低于对照组(P<0.05)。两组患侧肺脏指数V95比较无显著差异(P>0.05);观察组患侧肺脏指数V105和V110低于对照组(P<0.05)。观察组心脏指数V30、V40和V50低于对照组(P<0.05)。结论:乳腺癌改良根治术后调强放疗与常规放疗疗效相当,而调强放疗对心脏和肺脏影响小,可减轻心脏和肺脏的放射性损伤。

Therapeutic effects of intensity-modulated radiotherapy and conventional radiotherapy on breast cancer after modified radical mastectomy and their effects on the heart and lungs

Objective To investigate the therapeutic effects of intensity-modulated radiotherapy(IMRT)and conventional radiotherapy(CRT)after modified radical mastectomy for breast cancer,and to study the effects of different radiotherapy modalities on the heart and lungs.Methods Sixty patients undergoing modified radical mastectomy for breast cancer were enrolled and divided into observation group(30 cases)and control group(30 cases)according to different radiotherapy modalities.The patients in observation group were treated with IMRT,while those in control group were treated with CRT.The short-term therapeutic effect,cardiac troponin and pulmonary function before and after radiotherapy,and the dosimetric indexes of the affected lung and the heart were compared between two groups.Results There was no significant difference in short-term therapeutic effect between two groups(P>0.05).The level of troponin in both two groups after radiotherapy was higher than that before radiotherapy(P<0.05),but the level of troponin in observation group after radiotherapy was lower than that in control group(P<0.05).After radiotherapy,the ejection fraction in both two groups was decreased,while LADs and LVDd were increased(P<0.05).Compared with those in control group,the ejection fraction in observation group after radiotherapy was higher,but LADs and LVDd were much lower(P<0.05).The difference between two groups in the V95 of the affected lung was insignificant(P>0.05),while the V105 and V110of the affected lung in observation group were lower than those in control group(P<0.05).Moreover,the heart index V30,V40 and V50 in observation group were lower than those in control group(P<0.05).Conclusion The therapeutic effects of IMRT and CRT for breast cancer after modified radical mastectomy are similar,and moreover,IMRT has trivial effects on the heart and lungs,thereby reducing radiation-induced damages to the heart and lungs.