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早期乳腺癌保乳术后瘤床同步整合与瘤床后程补量IMRT研究
徐敏, 王素贞, 王玮, 邵倩, 张英杰, 李奉祥, 李建彬
山东省肿瘤防治研究院(山东省肿瘤医院) 山东第一医科大学(山东省医学科学院),济南 250117
Comparison of clinical efficacy between simultaneous integrated boostintensity-modulated radiotherapy (SIB-IMRT) and late-course boost intensity-modulated radiotherapy (LB-IMRT) for early-stage breast cancer after breast-conserving surgery
Xu Min, Wang Suzhen, Wang Wei, Shao Qian, Zhang Yingjie, Li Fengxiang, Li Jianbin
Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji′nan 250117,China
Abstract：Subject To compare the irradiation-induced injury and clinical efficacy between SIB-IMRT and LB-IMRT for early-stage breast cancer after breast-conserving surgery. Methods From November 2002 to February 2012, 353 early breast cancer patients who underwent IMRT after breast-preserving surgery at Shandong Cancer Hospital were selected, of whom 218 patients receiving SIB-IMRT and 135 patients receiving LB-IMRT.The prescription dose of the SIB-IMRT group was the ipsilateral breast (PTVb )1.8-1.9 Gy, 27-28 times, and concurrent tumor bed (PTVt) 2.15-2.3 Gy, 27-28 times. In the LB-IMRT group, the prescription dose was PTVb 2.0 Gy, 25 times, followed by PTVt boost 2.0 Gy, 5-8 times. Results The median follow-up time was 92 months. The excellent, good, fair, and poor cosmetic results in the SIB-IMRT and LB-IMRT groups were 10.1% and 12.6%, 85.8% and 80.7%, 3.7% and 5.2%, 0.5%, and 0.7%, respectively (P=0.731). The 5-year locoregional recurrence rates (LRRs) in the SIB-IMRT and LB-IMRT groups were 3.21% and 5.93% and the 10-year LRRs were 4.13% and 6.67%, respectively (P=0.209, 0.280). The 3-, 5-, 8-, and 10-year overall survival rate in the SIB-IMRT and LB-IMRT groups were 97.7% and 97.8%, 96.3% and 95.2%, 94.9% and 92.0%, 93.6% and 90.3%, respectively (P=0.288). The 3-, 5-, 8-, and 10-year disease-free survival in the SIB-IMRT and LB-IMRT groups were 95.4% and 93.8%, 91.8% and 87.7%, 89.9% and 84.1%, 89.0% and 82.1%, respectively (P=0.160). Conclusion There is no significant difference in the cosmetic effect, local control rate, and survival rate between SIB-IMRT and LB-IMRT after breast-preserving surgery in patients with early-stage breast cancer. SIB-IMRT is a safe and feasible treatment.
Xu Min,Wang Suzhen,Wang Wei et al. Comparison of clinical efficacy between simultaneous integrated boostintensity-modulated radiotherapy (SIB-IMRT) and late-course boost intensity-modulated radiotherapy (LB-IMRT) for early-stage breast cancer after breast-conserving surgery[J]. Chinese Journal of Radiation Oncology, 2020, 29(11): 948-953.
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2020, Vol. 29 
