Analysis of Radiotherapy optimization scheme after modified radical mastectomy / 中国综合临床

ABSTRACT

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.