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目的探讨延迟放疗对乳腺癌保乳手术后患者生存状况的影响。方法选取乳腺癌保乳手术患者150例,按随机数表法将患者分为对照组和观察组,每组75例。两组患者行乳房保留术后,对照组行常规放疗后辅助化疗;观察组根据患者具体情况,先行辅助化疗,再行放疗,延迟>8周。观察并统计两组患者的术后局部复发(LR)、总生存(OS)、不良反应情况。结果术后3年,观察组及对照组LR率分别为20.00%(15/75)和36.00%(27/75),差异有统计学意义(χ~2=4.631,P=0.031);观察组及对照组OS率分别为94.67%和86.67%,差异无统计学差异(χ~2=2.953,P=0.134)。观察组并发症1例,为皮下积液,转移2例;对照组并发症6例,其中皮下积液6例。转移8例,两组比较具显著差异(P<0.05);治疗后观察组和对照组角色功能、情绪功能、社会功能和躯体功能等各项生活质量评分分别为(81.3±3.4)、(69.1±4.8)、(80.5±5.1)、(79.5±6.1)和(70.3±2.6)、(55.9±3.3)、(60.2±4.1)、(65.1±5.8)分,两组各项比较差异显著,具统计学意义(P<0.05);观察组美容效果优良率为97.33%,高于对照组86.67%,差异具有统计学意义(χ~2=8.631,P=0.003)。结论延迟放疗能对乳腺癌保乳手术患者患者生存状况产生积极影响,预后效果较好,患者生活质量明显提高,值得临床推广。
Objective To investigate the effect of delayed radiotherapy on the survival of breast cancer patients after breast-conserving surgery. Methods 150 breast conserving surgery patients were selected. The patients were divided into control group and observation group according to random number table method, with 75 cases in each group. Two groups of patients underwent breast retention surgery, the control group after conventional radiotherapy adjuvant chemotherapy; observation group according to the specific circumstances of patients, first adjuvant chemotherapy, followed by radiotherapy, delayed> 8 weeks. The postoperative local recurrence (LR), overall survival (OS) and adverse reactions were observed and statistically analyzed. Results After 3 years of operation, the LR rates of the observation group and the control group were 20.00% (15/75) and 36.00% (27/75) respectively, with significant difference (χ ~ 2 = 4.631, P = 0.031) OS rates were 94.67% and 86.67% in the control group, respectively, with no significant difference (χ ~ 2 = 2.953, P = 0.134). One case of complication observed in the observation group was subcutaneous fluid and 2 cases of metastasis. The control group had 6 cases of complication, including 6 cases of subcutaneous fluid. (P <0.05). After treatment, the quality of life scores in the observation group and the control group were (81.3 ± 3.4), (69.1), emotional function, social function and somatic function respectively ± 4.8), (80.5 ± 5.1), (79.5 ± 6.1) and (70.3 ± 2.6), (55.9 ± 3.3), (60.2 ± 4.1) and (65.1 ± 5.8) (P <0.05). The excellent and good rate of the cosmetic effect in the observation group was 97.33%, which was higher than that in the control group (86.67%). The difference was statistically significant (χ ~ 2 = 8.631, P = 0.003). Conclusion Delayed radiotherapy can have a positive impact on the survival of patients with breast conserving surgery, the prognosis is better, and the quality of life of patients is significantly improved, which is worthy of clinical promotion.