乳腺癌保乳术后大分割与常规分割放疗的皮肤副作用及美容效果比较：基于倾向性评分匹配法

周略; 李子煌; 杨东; 邓小年; 张定; 吕得刚; 李先明; 唐娜

doi:10.12122/j.issn.1674-4500.2021.05.03

文章导航 > 分子影像学杂志 > 2021 > 44(5): 744-748

周略, 李子煌, 杨东, 邓小年, 张定, 吕得刚, 李先明, 唐娜. 乳腺癌保乳术后大分割与常规分割放疗的皮肤副作用及美容效果比较：基于倾向性评分匹配法[J]. 分子影像学杂志, 2021, 44(5): 744-748. doi: 10.12122/j.issn.1674-4500.2021.05.03

引用本文:

ZHOU Lue, LI Zihuang, YANG Dong, DENG Xiaonian, ZHANG Ding, LV Degang, LI Xianming, TANG Na. Comparison of skin side effection and cosmetic effection of postoperative hypofraction and conventional fractional radiotherapy for early breast cancer patiens with breast-conserving surgery: based on propensity score matching method[J]. Journal of Molecular Imaging, 2021, 44(5): 744-748. doi: 10.12122/j.issn.1674-4500.2021.05.03

Citation:

ZHOU Lue, LI Zihuang, YANG Dong, DENG Xiaonian, ZHANG Ding, LV Degang, LI Xianming, TANG Na. Comparison of skin side effection and cosmetic effection of postoperative hypofraction and conventional fractional radiotherapy for early breast cancer patiens with breast-conserving surgery: based on propensity score matching method[J]. Journal of Molecular Imaging, 2021, 44(5): 744-748. doi: 10.12122/j.issn.1674-4500.2021.05.03

引用本文:

Citation:

ZHOU Lue, LI Zihuang, YANG Dong, DENG Xiaonian, ZHANG Ding, LV Degang, LI Xianming, TANG Na. Comparison of skin side effection and cosmetic effection of postoperative hypofraction and conventional fractional radiotherapy for early breast cancer patiens with breast-conserving surgery: based on propensity score matching method[J]. Journal of Molecular Imaging, 2021, 44(5): 744-748. doi: 10.12122/j.issn.1674-4500.2021.05.03

乳腺癌保乳术后大分割与常规分割放疗的皮肤副作用及美容效果比较：基于倾向性评分匹配法

doi: 10.12122/j.issn.1674-4500.2021.05.03

周略^1,,
李子煌¹,
杨东¹,
邓小年¹,
张定¹,
吕得刚¹,
李先明¹,
唐娜^2, ,

1.
深圳市人民医院（暨南大学第二临床医学院/南方科技大学第一附属医院）肿瘤放疗科，广东深圳 518020
2.
深圳市人民医院（暨南大学第二临床医学院/南方科技大学第一附属医院）病理科，广东深圳 518020

基金项目: 国家自然科学基金青年项目（81702359）；深圳市科技计划项目（JCYJ20180301170035531）

详细信息

作者简介:
周略，硕士，主治医师，E-mail: zhoulue@163.com

通讯作者:
唐娜，博士，副主任医师，E-mail: tangna1225@163.com

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出版历程
- 收稿日期: 2021-07-11
- 刊出日期: 2021-09-20

Comparison of skin side effection and cosmetic effection of postoperative hypofraction and conventional fractional radiotherapy for early breast cancer patiens with breast-conserving surgery: based on propensity score matching method

1.
Department of Radiation Oncology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University/The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, China
2.
Department of Pathology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University/The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, China

Funds: Supported by National Natural Science Foundation of China (81702359)

摘要

摘要: 目的使用倾向性评分匹配法对组间协变量进行均衡处理后，比较乳腺癌保乳术后大分割放疗与常规分割放疗的美容效果和皮肤副反应。方法回顾性分析2015年1月~2018年7月在深圳市人民医院进行放射治疗的319例保乳术后的乳腺癌患者，其中大分割放疗组215例，常规分割放疗组104例，通过对两组患者进行倾向性评分匹配，获得协变量均衡的两组新样本，并对这两组样本进行分析。结果经过倾向性评分匹配后的常规分割放疗组99例，大分割放疗组100例。两组患者I级早期皮肤副反应分别为67.6%和78%，分别有14.1%和10%的患者出现湿性脱皮，差异无统计学意义（P=0.111）。在第6月、1年、2年的I级皮肤副反应发生率分别为86.9%，90.0%；96.0%，92.0%；99.0%，96.0%，（P=0.471），两组均未出现III级及以上的晚期皮肤毒副作用。2年后常规分割组与大分割组美容评价良好率分别为78.8%、84.0%（P=0.361）。结论对于早期乳腺癌保乳术后的辅助放疗，大分割放疗与常规放疗的皮肤毒副反应和美容效果均无显著差异。
- 早期乳腺癌 /
- 大分割放疗 /
- 常规放疗 /
- 早期皮肤副反应 /
- 晚期皮肤副反应 /
- 美容效果
Abstract: Objective To compare the side effection of skin and cosmetic scores between postoperative hypofraction radiotherapy and convention fraction radiotherapy for early breast cancer patiens with breast-conserving surgery, through balancing the covariates of the two groups with propensity score matching method. Methods The patients (n=319) who underwent breast-conserving surgery at Shenzhen People's Hospital from Jan. 2015 to Jul. 2018 were retrospectively analyzed. There were 104 patients in the hypofraction radiotherapy group and the other 215 patients in the convention fraction radiotherapy group, which matched by propensity scores to obtain two new groups with balanced covariates.We analyzed the samples of the two groups. Results There were 99 patients in the convention fraction radiotherapy group and 100 patients in the hypofraction radiotherapy group after propensity score matched. There were 86.9% and 90% patients presented early skin side effection, respectively. The 14.1% and 10% of patients in the two groups occured wet peeling, which had no significant difference (P=0.111). The incidence of grade I skin side effection in the two groups at 6 months, 1 year, and 2 years were 86.9%, 90.0%; 96.0%, 92.0%; 99.0%, 96.0%(P=0.471). There were no late grade III or worse skin side effection in the two groups. The good rates of cosmetic scores between the convention fraction radiotherapy group and hypofraction radiotherapy group were 78.8% and 84.0% (P=0.361) after 2 years. Conclusion There is no significant difference in side effection of skin or cosmetic scores between postoperative hypofraction radiotherapy and convention radiotherapy for early breast cancer patiens with breast-conserving surgery.
- early breast cancer /
- hypofractionated radiotherapy /
- conventional fraction radiotherapy /
- early side effection of skin /
- late side effection of skin /
- cosmetic effection of breast

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图 1 常规放疗剂量分布图

A：横断面；B：矢状面；C：冠状面.

Figure 1. Dose distribution of convention radiotherapy.

下载: 全尺寸图片幻灯片

图 2 大放疗剂量分布图

A：横断面；B：矢状面；C：冠状面.

Figure 2. Dose distribution of hypofraction radiotherapy.

下载: 全尺寸图片幻灯片

表 1 倾向性评分前后常规分割和大分割放疗患者临床基本资料比较

Table 1. The characteristic clinical datas of patients with conventional and hyperfractionated radiotherapy before and after propensity score

变量	匹配前				匹配后
变量	常规放疗(n=215)	大分割放疗(n=104)	x²	P	常规放疗(n=99)	大分割放疗(n=100)	x²	P
年龄(岁）			2.171	0.141			0.015	0.904
> 35	172	76			74	74
≤35	42	28			25	26
T分期			4.095	0.129			0.245	0.620
T1	124	68			61	65
T2	91	36			38	35
N分期			2.592	0.107			0.613	0.434
N0	128	52			45	49
N1	87	52			54	51
脉管侵犯			0.060	0.807			2.415	0.120
阳性	123	61			67	43
阴性	92	43			32	57
神经侵犯			0.989	0.320			1.813	0.178
阳性	103	56			54	45
阴性	112	48			45	55
化疗			1.490	0.475			1.018	0.601
是	178	91			86	88
否	36	13			13	12
月经状态			0.372	0542			0.676	0.411
绝经前	150	76			32	27
绝经后	65	28			67	73

下载: 导出CSV

表 2 早期皮肤反应

Table 2. Early reaction of skin[n(%)]

早期反应分级	常规放疗(n=99)	大分割放疗(n=100)
I级	67(67.7)	78(78.0)
II级	18(18.2)	12(12.0)
III级	14(14.1)	10(10.0)
IV级	0(0.0)	0(0.0)
P=0.111.

下载: 导出CSV

表 3 晚期皮肤反应

Table 3. Late reaction of skin[n(%)]

晚期反应分级	常规放疗(n=99)	大分割放疗(n=100)	P
6月			0.491
I级	86(86.9)	90(90.0)
II级	13(13.1)	10(10.0)
III级及以上	0(0.0)	0(0.0)
1年			0.242
I级	95(96.0)	92(92.0)
II级	4(4.0)	8(8.0)
III级及以上	0(0.0)	0(0.0)
2年			0.179
I级	98(99.0)	96(96.0)
II级	(1.0)	4(4.0)
III级及以上	0(0.0)	0(0.0)

下载: 导出CSV

表 4 美容评分

Table 4. Score of cosmetic[n(%)]

美容评价	常规放疗(n=99)	大分割放疗(n=100)	P
1月			0.546
优秀	5(5.1)	6(6.0)
良好	74(74.7)	77(77.0)
一般	17(17.2)	14(14.0)
差	3(3.0)	3(3.0)
6月			0.872
优秀	7(7.1)	6(6.0)
良好	78(78.8)	80(80.0)
一般	13(13.1)	12(12.0)
差	(1.0)	2(2.0)
1年			0.490
优秀	8(8.1)	8(8.0)
良好	80(80.8)	85(85.0)
一般	1(11.1)	7(7.0)
差	0(0.0)	0(0.0)
2年			0.877
优秀	1(11.1)	9(9.0)
良好	78(78.8)	84(84.0)
一般	10(10.1)	7(7.0)
差	0(0.0)	0(0.0)

下载: 导出CSV

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