Objective To observe the therapeutic effects ,cosmetic results ,and toxicities of central hypo-fractionated intensity modulated radiotherapy for patients with early-stage breast cancer after breast-conserving surgery .Methods From June 2014 to March 2015 ,37 patients with pTis-2N0M0 breast cancer after breast-con-serving surgery were enrolled in the trial .Intensity modulated conformal radiotherapy or simplified intensity modu-lated radiotherapy was applied to each patient .The hypofractionated radiotherapy schedule was 42.56 Gy/16 frac-tions to the whole breast .With a boost of 10 Gy/5 fractions to the tumor bed .The total course of treatment was 29 days .Locoregional control and overall survival were calculated by Kaplan-Meier method .Results The follow-up rate was 100％ .The 2-year local regional control and overall survival were both 100％ ,and 6 developed grade 2 upper extremity edema ,3 developed grade 1 radiation pneumonitis ,and 2 developed grade 2 radiation pneumoni-tis .Compared with the conventional fractionated radiotherapy for the patients with early-stage breast cancer after breast-conserving surgery ,the hypofractionated intensity modulated radiotherapy had the number of fractions ra-diotherapy decreased from 30 to 21 .Course of treatment shortened from 42 days to 29 days .and the cost cut from￥30375 to ￥19575 .Conclusion The central hypofractionated intensity modulated radiotherapy for the patients with early-stage breast cancer after breast-conserving surgery have good therapeutic effects and cosmetic results and acceptable toxicities ,and it as well significantly reduced time and cost of treatment .%目的 观察早期乳腺癌保乳术后采用大分割调强放疗的近期疗效、不良反应和美容效果.方法2014年6月至2015年3月保乳术后行调强放疗的37例pTis-2N0M0期乳腺癌患者.全乳42.56 Gy/16次,瘤床补量10 Gy/次,总疗程29 d.局部区域控制率和总生存率用Kapian-Meier法计算.结果随访率100％.2年局部区域控制率、生存率均为100％;上肢水肿6例;1、2级放射性肺炎分别为3、2例;美容效果满意率占92％;与同期保乳术后常规分割放疗相比,放疗次数由30次降至21次,疗程由42 d缩短至29 d,费用由30375元降至19575元.结论乳腺癌保乳术后全乳三维调强大分割放疗组患者选择恰当,局部控制、不良反应和美容评价初步结果较好,且能显著降低治疗时间和费用.
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