RESUMO
Objective To study the application value of radiotherapy optimization after modified radical mastectomy.Methods From January 2012 to January 2015,one hundred and twelve patients treated with modified radical mastectomy in Taizhou Cancer Hospital were enrolled and divided randomly into group A,B and C.40 patients in group A received modulated radiation therapy(MRT) with 2.0Gy/f,25 times,DT50Gy for 33-35d;35 cases in group B received concurrent chemoradiotherapy with MRT and 37 cases in group C received concurrent chemoradiotherapy with large segmentation scheme of 2.66Gy/f,16 times,DT42.56Gy for 22-24d.The recurrence rate,survival rate and the incidence of acute and chronic radiation injury of the 3 groups were compared.The parameters of V5,V10,V20 and V30 of ipsilateral lung was recorded by dose volume histogram(DVH).Results The total recurrence rate in group C was significantly lower than that of the other two groups (16.2％(6/37) vs.28.6％(10/35) vs.42.5％(17/40),x2 =6.409,P=0.041),while the total survival rate was significantly higher than that of the other two groups (89.2％ (33/37) vs.77.1％ (27/35) vs.65.0％ (26/40),x2 =6.313,P =0.043),and there was no significant difference in the local recurrence and distant metastasis rate in the 3 groups (P＞0.05).The incidence of total radiation injury in group C was lower than that of the other two groups (21.6％ (8/37) vs.42.9％ (15/35) vs.50％ (20/40),x2 =6.973,P =0.031),and there was no significant difference in the incidence of acute and chronic injury and the grade of injury in the 3 groups (P＞0.05).The values of VS,V10,V20 and V30 increased gradually in the 3 groups.The V5 and V10 in group C were significantly higher than those of the other two groups ((32.9 ± 7.4) ％ vs.(17.5 ± 5.9) ％ vs.(16.8 ± 6.4) ％,F =18.625,P=0.000,(42.4±7.3)％ vs.(39.3±5.8)％ vs.(35.5±6.0)％,F=15.624,P=0.000),and there was no significant difference in V20 and V30 among the three groups (P＞ 0.05).Conclusion The combination of concurrent chemoradiotherapy and breast cancer after modified radical mastectomy is of great value in improving prognosis and reducing radiation damage.
RESUMO
Objective To explore the clinical efficacy and the dynamic changes of serum vascular endothelial growth factor(VEGF),connective tissue growth factor(CTGF),hypoxia inducible factor 1α(HIF-1α)and osteopontin(OPN)levels after transcatheter arterial chemoembolization(TACE)combined with sorafenib in the treatment of advanced hepatocarcinoma(HCC)patients.Methods A total of 113 HCC patients in Cancer Hospital of Taizhou,from September 2013 to December 2014 were elected and were randomly divided into control group(n=56)and experiment group(n=57)according to random number.Control group were treated with sorafenib and experiment group were treated with TACE combined with sorafenib.The serum VEGF,CTGF,HIF-1α and OPN levels were tested and compared using indirect ELISA method preoperative and postoperative 1,3,7 days and which were carried out Spearman correlation analysis.The long-term clinical efficacy and adverse reaction in two groups were statisticed.Results The serum VEGF,CTGF,HIF-1α and OPN levels of two groups postoperative 1 day increased than preoperative(P0.05).Conclusion The levels of VEGF,CTGF,HIF-1α and OPN of HCC patients after treated with TACE combined with sorafenib are lower than that treated with TACE alone,Simultaneously,the survival is prolonged and adverse reactions don't increase.