| BackgroundBreast conserving surgery combined with whole breast radiotherapy is one of the most important treatment modes for early breast cancer.Previous clinical studies have confirmed that the clinical efficiency of breast-conserving surgery combined with radiotherapy for early breast cancer is similar to that of radical mastectomy,and the breast-conserving therapy retain the physiological integrity of breast and improve the quality of life of patients.However,conventional radiotherapy after breast-conserving surgery takes a relatively long time,which causes certain psychological and economic pressure on patients,resulting in a decline in the compliance of treatment choices of some patients.By increasing the fractionation dose and reducing the fractions,the hypofractionated whole breast irradiation(HF-WBI)shortens the treatment course of radiotherapy on the basis of keeping the total biological effective dose basically unchanged.Some studies have shown that compared with conventional fractionated Whole Breast Irradiation(CF-WBI),there is no significant difference in local regional control rate and overall survival rate between the hypofractionation and conventional fractionation radiotherapy.Because of its short treatment time,the hypofractionated whole breast irradiation(HF-WBI)has obvious advantages in treatment choice.The hypofractionated whole breast irradiation(HF-WBI)has been the focus of research in recent years,and some clinical problems such as the optimal fractionation dose have not been determined,so it is worthy of further clinical research.ObjectiveTo evaluate the efficacy,adverse reactions and cosmetic effect of hypofractionated whole breast irradiation(HF-WBI)after breast conserving surgery for breast cancer.MethodsA retrospective analysis was made on 170 female patients with early breast cancer who received whole breast radiotherapy after breast conserving surgery from January2015 to January 2019.Among them,83 patients were treated with the hypofractionated whole breast irradiation(HF-WBI group).Dose fractionation mode:whole breast2.66～3.2Gy/fraction,41.6～42.5Gy/13～16 fractions.The sequential tumor bed boost was8～12Gy/4～6 fractions,and the total radiotherapy time was 25-30 days.87 patients received the conventional fractionated Whole Breast Irradiation(CF-WBI group),whole breast 2Gy/fraction,46～50Gy/23～25 fractions,sequential tumor bed boost 10～14 Gy/5～7 fractions,total radiotherapy time 42-45 days.6MV-X ray three-dimensional conformal radiotherapy was adopted.The data of the two groups were compared and analyzed to evaluate the efficacy,safety and cosmetic effect of HF-WBI in patients after breast-conserving surgery.Statistical processing:SPSS version 19.0 was used for statistical analysis.The countable data were analyzed byχ~2test,the measurement data by t-test.The survival rate was calculated by Kaplan-Meier method and Log-rank test.ResultsThe 1-,2-,and 3-year survival rates of HF-WBI group and CF-WBI group were96.38%and 95.41%,85.54%and 82.76%,78.31%and 75.86%,respectively;the 3-year distant metastasis rates of the two groups were 1.2%and 3.45%;the 3-year local recurrence rates were 6.02%and 8.04%;and the excellent rates of breast cosmetic effect were 91.57%and 85.05%,respectively;there was no statistical difference between the two groups(P>0.05).There was no significant difference in the incidence of acute adverse reactions of II grade skin(16.87%,13.79%),late radiation injury of breast skin(24.10%,20.68%),neutropenia(10.84%,8.04%),and thrombocytopenia(3.61%,2.29%)between the HF-WBI and the CF-WBI groups.There was no significant difference in the score of quality of life between HF-WBI and CF-WBI groups during radiotherapy.ConclusionsThe clinical efficacy of HF-WBI is similar to that of CF-WBI in patients with early breast cancer after breast-conserving surgery,and the incidence of treatment-related adverse reactions is similar,and it shortens the time of radiotherapy and reduces the cost of treatment,so it may have a good prospect in clinical application. |
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