摘要
目的 探讨放疗联合保乳手术对乳腺癌患者免疫功能及生存状况的影响。方法 选取2017年1月至2020年1月间青岛大学附属青岛市中心医院收治的70例乳腺癌患者,随机分为观察组和对照组,每组35例。观察组患者采用保乳手术联合术后放疗治疗,对照组患者采用乳腺癌根治术治疗,比较两组患者的临床疗效、免疫功能、生存状况及观察组放疗不良反应。结果 观察组患者美容效果优良率为94.3%,高于对照组的77.1%,差异有统计学意义(P<0.05)。治疗后,两组患者CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均降低,CD8^(+)水平均升高,且观察组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组,差异均有统计学意义(均P<0.05)。术后随访1年,观察组患者局部复发率为17.1%(6例),对照组为31.4%(11例)^(+)观察组患者总生存率为94.3%(33例),对照组为82.9%(29例),两组比较,差异均有统计学意义(均P<0.05)。观察组患者出现急性皮肤损伤、放射性口腔黏膜炎、放射性肠炎、放射性食管炎、放射性肺炎及心脏损伤等不良反应,但症状均较轻,多数为0~1级,其中急性皮肤损伤和放射性食管炎发生率较高,分别为100.0%和25.7%。结论 放疗联合保乳手术治疗乳腺癌效果较好,能改善患者的免疫功能及生存状况,值得临床推广使用。
Objective To investigate the effects of radiation therapy and breast conserving surgery on the function of immune system and survival in breast cancer patients. Methods Seventy breast cancer patients admitted to Qingdao Central Hospital Affiliated to Qingdao University were selected from January 2017 to January 2020. They were divided into an observation group and a control group with 35 patients in each group. The observation group received radiotherapy and breast conserving surgery and the control group underwent radical mastectomy. Clinical efficacy, function of the immune system, survival status and radiotherapy-related adverse reactions were compared between the two groups. Results The excellent/good cosmesis was 94.3% in the observation group than 77.1% of the control group(P<0.05). After the treatment, improved CD3^(+), CD4^(+)and CD4^(+)/CD8^(+)levels decreased and CD8^(+)levels increased in both groups compared with those prior to the treatment, and the improvement in the observation group was better than in the control group(all P<0.05). After a 1-year follow-up, the local recurrence rate was 17.1%(6 patients) in the observation group and 31.4% in the control group and the overall survival rate was 94.3% in the observation group and 82.9% in the control(all P<0.05). Patients in the observation group suffered from adverse reactions such as acute skin injury, radiation oral mucositis, radiation enteritis, radiation esophagitis, radiation pneumonia and heart injury. The majority of the symptoms are grades 0 to 1. The incidence of acute skin injury and radiation-induced esophagitis was relatively high, which accounted for 100% and 25.71%, respectively. Conclusion Radiation therapy combined with breast conserving surgery shows good efficacy. It improves function of the immune system and living condition, and deserves clinical promotion.
作者
徐燕
程丕叶
杜美春
张佩娟
XU Yan;CHENG Pi-ye;DU Mei-chun;ZHANG Pei-juan(Department of Stereotactic Radiotherapy,Qingdao Central Hospital Affiliated to Qingdao University,Qingdao 266042,China;Second Department of Radiotherapy,Qingdao Central Hospital Affiliated to Qingdao University,Qingdao 266042,China;Cancer Prevention and Treatment Center,Qingdao Central Hospital Affiliated to Qingdao University,Qingdao 266042,China;Department of Scientific Research Management,Qingdao Central Hospital Affiliated to Qingdao University,Qingdao 266042,China)
出处
《中国肿瘤临床与康复》
2022年第6期653-656,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
放射治疗
保乳手术
乳腺肿瘤
免疫功能
生存状况
Radiotherapy
Breast conserving surgery
Breast neoplasms
Function of the immune system
Survival condition
