Abstract：Objective: To explore the application value of intensity modulated radiation technology and three-dimensional conformal technique with tangent field in breast cancer patients after breast conserving surgery. Methods: 82 patients with breast cancer after breast-conserving surgery in our hospital from November 2017 to November 2019 were selected. They were divided into intensity-modulated group and conformal group, with 41 patients in each group. The conformal group adopts the tangent field three-dimensional conformal technology, and the intensity-modulated group adopts the intensity-modulated radiation technology. The dose distribution of whole milk target area, total lung volume, cardiac volume, relative expression levels of miR-765 and miR-21 before and after treatment, levels of T cell subgroup indicators, and occurrence of toxicities were calculated. Results: CI and Dmean in the intensity-modulated group were higher than those in the conformal group, HI and Dmax were lower than those in the conformal group (P<0.05), and there was no significant difference in Dmin between the two groups (P>0.05); Dmean and V5 in the intensity-modulated group were lower than those in the conformal group (P<0.05), and there was no significant difference in V20 between the two groups (P>0.05); Dmean, V20 and V40 in the intensity-modulated group were lower than those in the conformal group (P<0.05); After treatment, the relative expression of miR-765 in the two groups was higher than that before treatment, and miR-21 was lower than that before treatment, the relative expression of miR-765 in the intensity-modulated group was higher than that in the conformal group, and miR-21 was lower than that in the conformal group (P<0.05);After treatment, the CD3+, CD4+, and CD4+/CD8+ in the two groups were lower than before treatment, and the CD8+ was higher than before treatment, but the CD3+, CD4+, CD4+/CD8+ in the IM group were higher than the conformal group, and the CD8+ was lower than the conformal group (P<0.05);The incidence of myelosuppression (29.27%) and acute skin reaction (63.41%) in the intensity-modulated group was lower than that in the conformal group (53.66%, 82.93%) (P<0.05). Conclusion: The results of intensity-modulated radiation therapy for breast cancer patients after breast conserving surgery are better than the three-dimensional conformal technique of tangent field, which can ensure the rationality of radiation dose in each region, have little impact on the immune function of patients, regulate the relative expression of miR-765 and miR-21, and reduce the risk of side effects to a certain extent, and ensure the safety.
童薇, 郑杰, 沈学明, 雍翔. 调强放射技术与切线野三维适形技术在乳腺癌保乳术后的应用价值[J]. 河北医学, 2020, 26(5): 778-784.
TONG Wei, ZHENG Jie, et al. Application Value of IMRT and Three-dimensional Conformal Technique of Tangent Field in Breast Cancer Patients after Breast Conserving Surgery. HeBei Med, 2020, 26(5): 778-784.
[1] 古晓东,亓昕,王庆安,等.乳腺癌保乳术后放射治疗中腋窝各站淋巴结实际覆盖剂量研究[J].中华放射医学与防护杂志,2018,38(6):434~438. [2] 王玮,孟英涛,宋远芳,等.乳腺癌改良根治术后不同放疗计划方式下内乳区非计划性受照剂量的比较研究[J].中华肿瘤杂志,2018,40(5):335~340. [3] Wee C W,Kang H C,Wu H G,et al.Intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy in rectal cancer treated with neoadjuvant concurrent chemoradiation: a meta-analysis and pooled-analysis of acute toxicity[J].Jpn Clin Oncol,2018,48(5):458~466. [4] 张文,施林心,刘亚洲,等.三维适形调强放疗在乳腺癌根治术中的应用[J].中国辐射卫生,2019,28(2):190~193. [5] Zapatero A,Roch M,Büchser D,et al.Reduced late urinary toxicity with high-dose intensity-modulated radiotherapy using intra-prostate fiducial markers for localized prostate cancer[J].Clin Transl Oncol,2017,19(9):1161~1167. [6] Bae B K,Kang M K,Kim J C,et al.Simultaneous integrated boost intensity-modulated radiotherapy versus 3-dimensional conformal radiotherapy in preoperative concurrent chemoradiotherapy for locally advanced rectal cancer[J].Radiat Oncol,2017,35(3):208~216. [7] 郭雪娟,孙雨云,贾凡.三维适形放射治疗与二维放射治疗对行保乳术的早期乳腺癌患者治疗效果的比较[J].中国临床实用医学,2019,10(1):51~53. [8] Rudat V,Nour A,Hammoud M,et al.Better compliance with hypofractionation vs. conventional fractionation in adjuvant breast cancer radiotherapy: Results of a single, institutional, retrospective study[J].Strahlenther Onkol,2017,193(5):375~384. [9] Meattini I,Saieva C,Miccinesi G,et al.Accelerated partial breast irradiation using intensity modulated radiotherapy versus whole breast irradiation: Health-related quality of life final analysis from the Florence phase 3 trial[J].Eur Cancer,2017,76(1):17~26. [10] 李振淼,宋博,赵怡.X射线调强放疗对乳腺癌保乳术后远期生存及免疫功能影响的临床观察[J].临床肿瘤学杂志,2019,24(2):158~162. [11] 魏世鸿,陶娜,欧阳水根,等.左侧乳腺癌根治术后IMRT和3D-CRT放疗技术剂量学比较[J].中华肿瘤防治杂志,2019,26(12):856~860. [12] Asia A,Ahmad ST,Arjumand W,et al.MicroRNAs in breast cancer: diagnostic and therapeutic potential[J].Methods Mol Biol,2018,1699(1):23~43.
2020, Vol. 26 
冀公网安备13080202000677号