背景:乳房切除术或保乳手术(BCS)后的辅助放疗是大多数乳腺癌患者的标准治疗方法。然而,这与危险器官(OAR)的粘膜和表皮毒性有关。乳腺癌患者会面临大量的错误认知,关于放射治疗的有用性和不良反应的错误信息和神话。关于加纳乳腺癌患者辐射引起的急性毒性的发生率和严重程度的文献很少。
目的:评估在加纳一家主要癌症治疗中心接受外照射放射治疗的女性乳腺癌患者中,四种主要急性放射性毒性的发生和严重程度。
方法:从患者病历中收集患者急性毒性发生的数据,通过半结构化问卷和每周临床评估。使用不良事件通用术语标准(CTCAE)分级量表(4.0版)对这些毒性的严重程度进行分级。使用独立的双抽样t检验(双尾)的描述性和推断性统计,单向方差分析(ANOVA),进行Pearson卡方检验和Fisher精确检验。
结果:皮炎,疲劳,咽炎,乳房(胸部)疼痛是在两台机器上接受治疗的乳腺癌患者中发现的辐射毒性。与皮炎发作相关的平均主要辐射剂量,疲劳,咽炎,乳腺癌患者的胸痛为22.32Gy,22.48Gy,13.59Gy,和19.27Gy治疗分别具有统计学意义(p=0.0173)。放射性皮炎是记录的最主要的急性放射毒性,以及发病率和严重程度。两台机器的急性辐射毒性之间的Fisherp值范围(0.689-0.999)没有统计学意义。
结论:放射性皮炎是主要的急性毒性,治疗患者的发病率和严重程度。急性放射副作用的发生率和严重程度无统计学意义。
BACKGROUND: Adjuvant radiotherapy after mastectomy or breast conserving surgery (BCS) is the standard of care for majority of patients with breast cancer. This is however associated with mucosal and epidermal toxicity of organs at risk (OARs). Breast cancer patients are exposed to a plethora of wrong perceptions, misinformation and myths concerning the usefulness and adverse effects of radiotherapy. There is paucity of literature on the incidence and severity of radiation-induced acute toxicities experienced by patients with breast cancer in Ghana.
OBJECTIVE: To assess the occurrence and severity of four main acute radiation-induced toxicities among female breast cancer patients treated with external beam radiotherapy at a major cancer treatment centre in Ghana.
METHODS: Data on the occurrence of acute toxicities among patients was collected from patients\' medical records, through a semi-structured questionnaire and via weekly clinical assessments. The Common Terminology Criteria for Adverse Events (CTCAE) grading scale (version 4.0) was used to grade the severity of these toxicities. Descriptive and inferential statistics using an independent two-sampled t-test (two-tailed), one-way analysis of variance (ANOVA), Pearson\'s Chi-square and Fisher\'s exact tests were performed.
RESULTS: Dermatitis, fatigue, pharyngitis, and breast (chest) pain were the radiation toxicities found among the breast cancer patients undergoing treatment on the two machines. The mean predominant radiation doses associated with the onset of dermatitis, fatigue, pharyngitis, and chest pain in the breast cancer patients were 22.32 Gy, 22.48 Gy, 13.59 Gy, and 19.27 Gy respectively for treatment with a statistically significant (p = 0.0173). Radiation dermatitis was the most dominant acute radiation toxicity recorded, and its incidence and severity. The range of Fisher\'s p-values (0.689-0.999) between the acute radiation toxicities with both machines revealed no statistical significance.
CONCLUSIONS: Radiation dermatitis was the dominant acute toxicity, both in incidence and severity for patients treated. There was no statistical significance in the incidence and severity of acute radiation side effects.