| 巩秦黎,张一贺,秦天燕,等.碳离子放射治疗乳腺癌的临床疗效与安全性:甘肃省武威肿瘤医院20例分析[J].肿瘤学杂志,2026,32(1):31-37. |
| 碳离子放射治疗乳腺癌的临床疗效与安全性:甘肃省武威肿瘤医院20例分析 |
| Clinical Efficacy and Safety of Carbon Ion Radiotherapy for 20 Cases with Breast Cancer from Gansu Wuwei Tumor Hospital |
| 投稿时间：2025-11-29 |
| DOI：10.11735/j.issn.1671-170X.2026.01.B006 |
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| 中文关键词: 碳离子 放射疗法 乳腺肿瘤 疗效 安全性 |
| 英文关键词:carbon ion radiotherapy breast neoplasms efficacy safety |
| 基金项目:甘肃省自然科学基金（23JRRH0006）；陇原青年创新创业人才基金（2021LQTD14）；甘肃中医药大学研究生创新基金（2026CXCY-168） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨碳离子放射治疗乳腺癌的疗效与安全性。［方法］回顾性分析甘肃省武威肿瘤医院碳离子放射治疗的20例乳腺癌患者临床资料，治疗方案依据肿瘤大小、距皮距离及病理类型个体化制定：采用多野照射技术降低皮肤受照剂量；全乳及淋巴引流区照射剂量为48 Gy［相对生物学效应（relative biological effectiveness， RBE）］/12 f，原发肿瘤补量 30~36 Gy（RBE）/3~4 f；转移淋巴结≥2 cm者加量至 60 Gy（RBE），分割为 4 Gy（RBE）/ f。采用实体瘤疗效评价标准1.1版进行疗效评估：于碳离子放射治疗结束时、碳离子放射治疗后1个月、3个月、6个月及12个月，通过MRI及超声检查图像进行疗效判定。末次随访时间为2025年6月1日，评估局部控制率、无进展生存期和总生存期。［结果］不良反应以Ⅰ级急性皮肤反应为主（13例），仅出现2例Ⅱ级皮肤反应、1例Ⅱ级放射性食管炎，无其他严重不良反应。至末次随访，10例完全缓解，6例部分缓解，4例病情稳定，无疾病进展。中位随访23.5个月，患者1年、2年局部控制率、无进展生存率及总生存率均达到100%；所有病例的美容效果均获评优异。［结论］ 碳离子放射治疗乳腺癌疗效确切，不良反应轻微可控，为不宜或不愿手术的患者提供了安全有效的非手术治疗选择，但仍需要更多样本和更长时间随访进一步评估。 |
| 英文摘要: |
| Abstract： ［Objective］ To evaluate the efficacy and safety of carbon ion radiotherapy (CIRT) for patients with breast cancer. ［Methods］ The clinical data of 20 breast cancer patients treated with CIRT at Gansu Wuwei Tumor Hospital were retrospectively analyzed. Individualized treatment plans were formulated based on tumor characteristics， employing multi-field irradiation to reduce skin dose. The prescribed dose was 48 Gy(relative biological effectiveness， RBE) in 12 fractions to the whole breast and regional lymph nodes， with a boost of 30~36 Gy(RBE) in 3~4 fractions to the primary tumor. Patients with metastatic lymph nodes ≥2 cm received an additional boost to 60 Gy(RBE) ， 4 Gy(RBE)/fraction. Treatment response was assessed using Response Evaluation Criteria in Solid Tumors v1.1 based on MRI and ultrasound findings at the end of CIRT and at 1， 3， 6， and 12 months post-treatment. The last follow-up was on June 1， 2025， evaluating local control， progression-free survival (PFS)， and overall survival (OS). ［Results］ Adverse events were predominantly mild： grade Ⅰ acute skin reactions occurred in 13 patients; only 2 had grade Ⅱ skin reactions and 1 had grade Ⅱ radiation esophagitis. No other severe adverse event was observed. At the last follow-up， 10 patients achieved complete response， 6 partial response， and 4 stable disease， with no disease progression. With a median follow-up of 23.5 months， the 1- and 2-year local control， PFS， and OS rates were all 100%. All patients had excellent cosmetic outcomes. ［Conclusion］ In this cohort， CIRT demonstrated favorable efficacy and a manageable safety profile for patients with breast cancer， representing a viable non-surgical option for patients unsuitable for or declining surgery. Further evaluation with larger samples and longer follow-up is warranted. |
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