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

doi:10.3969/j.issn.1006-6233.2020.05.019

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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.

Key words： IMRT technology Tangential field three-dimensional conformal technology Breast cancer Immune function

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.05.019 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I5/778

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