Olivotto I A, Kim-Sing C, Bajdik C D, Trevisan C H, Ludgate C M, Weir L M, Jackson S M, Basco V E
Division of Radiation Oncology, British Columbia Cancer Agency, Vancouver, Canada.
Radiother Oncol. 1996 Oct;41(1):1-6. doi: 10.1016/s0167-8140(96)91825-3.
Acetylsalicylic acid (ASA) can reduce the incidence of stroke and myocardial infarction by inhibiting platelet-fibrin thrombi in small blood vessels. To determine if ASA could reduce late effects of radiation therapy mediated by damage to small blood vessels, a prospective, placebo-controlled, double-blind trial was conducted in women with early breast cancer, receiving radiotherapy to the conserved breast.
Cosmetic outcome and late radiotherapy effects were recorded prospectively for 186 women with T1 or T2, pathologically node-negative breast cancer treated with breast conservation and randomized to receive ASA (325 mg daily) or placebo for 1 year from the start of radiation therapy. Radiation was a tangent pair to the breast alone delivering a modal dose of 44 Gy in 16 daily fractions in 22-25 days.
Median follow-up is 6.5 years. The use of ASA has not had any effect on the acute (erythema, edema or discomfort) or late (induration, telangiectasia) effects of radiotherapy (all P > 0.10), the patients' or physicians' assessment of the cosmetic outcome (all P > 0.25) or rates of breast recurrence (P > 0.25).
ASA cannot be recommended to improve the outcome of radiotherapy complementing breast conserving surgery.
阿司匹林（ASA）可通过抑制小血管内血小板 - 纤维蛋白血栓形成来降低中风和心肌梗死的发生率。为了确定ASA是否能减轻由小血管损伤介导的放射治疗的晚期效应，对接受保乳放疗的早期乳腺癌女性患者进行了一项前瞻性、安慰剂对照、双盲试验。
前瞻性记录了186例T1或T2期、病理检查腋窝淋巴结阴性的乳腺癌女性患者的美容效果和放疗晚期效应，这些患者接受了保乳治疗，并在放疗开始后随机分组，接受ASA（每日325毫克）或安慰剂治疗1年。放疗采用仅针对乳房的切线野照射，在22 - 25天内分16次给予44 Gy的标准剂量。
中位随访时间为6.5年。使用ASA对放疗的急性效应（红斑、水肿或不适）或晚期效应（硬结、毛细血管扩张）、患者或医生对美容效果的评估（所有P > 0.25）或乳腺复发率（P > 0.25）均无任何影响。
不建议使用ASA来改善保乳手术联合放疗的治疗效果。
