Department of Clinical Oncology and Nuclear Medicine, Mansoura University Hospitals, Mansoura, Egypt.
Med Oncol. 2012 Dec;29(4):2570-6. doi: 10.1007/s12032-012-0192-1. Epub 2012 Feb 22.
To compare three fractionation schedules in post-mastectomy patients treated with radiotherapy as regard acute and early late effects as well as local recurrence rates. One hundred and seven breast cancer patients treated with modified radical mastectomy and adjuvant radiotherapy±adjuvant systemic treatments between November 2001 and July 2004 were enrolled in this study. Patients were categorized into three groups. Group A (41 patients) received conventional fractionation 50 Gy over 25 fractions. Group B (36 patients) received other fractionation regimen 45 Gy over 17 fractions. Group C (30 patients) received 40 Gy over 15 fractions. The median follow-up period was 23 months. There has been no statistical significant difference in local control (P=0.88), pain (P=0.98), telangectasis (P=0.23), fibrosis (P=0.13), arm oedema (P=0.96) or pigmentation (P=0.80) between the three groups. GII-III Erythema was significantly higher in the two hypofractionation arms compared to the control arm (P=0.001). Although acute skin reactions were higher in the hypofractionated arms, there was no significant difference in the local recurrence rates or late radiation effects. A national randomized multicentre study is recommended to explore this further.
比较三种不同放疗分割方案在乳腺癌根治术后患者中的应用，主要比较其急性及早期晚期毒性反应和局部复发率。2001 年 11 月至 2004 年 7 月，我们对 107 例接受改良根治术和辅助放疗±辅助全身治疗的乳腺癌患者进行了这项研究。患者被分为三组：A 组（41 例）接受常规分割 50Gy/25 次；B 组（36 例）接受其他分割方案 45Gy/17 次；C 组（30 例）接受 40Gy/15 次。中位随访时间为 23 个月。三组患者的局部控制率（P=0.88）、疼痛（P=0.98）、毛细血管扩张（P=0.23）、纤维化（P=0.13）、手臂水肿（P=0.96）或色素沉着（P=0.80）差异均无统计学意义。与对照组相比，两组低分割组的 GII-III 级红斑发生率明显更高（P=0.001）。尽管低分割组的急性皮肤反应更高，但局部复发率和晚期放射毒性无显著差异。建议开展全国性随机多中心研究对此进行进一步探索。
