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在随机乳腺癌试验SENOMACAC中,肩关节辐射剂量与手臂发病率之间的关联

Sara Alkner¹, Matilda Appelgren², Robert Szulkin²

¹Department of Oncology, Faculty of Medicine, Institute of Clinical Sciences Lund, Lund University, Lund, Sweden; Skåne University Hospital Lund, Department of Hematology, Oncology and Radiation Physics, Lund, Sweden.

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

|February 23, 2026

概括

在哨兵淋巴结活检后,高剂量辐射到肩关节可能会增加乳腺癌患者的手臂发病率. 需要进一步的研究来确定放射治疗的明确剂量限制.

科学领域:

在瘤学瘤学.
辐射疗法辐射疗法
临床试验临床试验

背景情况:

手术后的淋巴结辐射是乳腺癌的常见治疗方法.
肩部发病率是已知的并发症,但缺乏具体的剂量限制.
在乳腺癌患者中,SENOMAC试验研究了状淋巴结解剖 (ALND) 与哨兵淋巴结活检 (SLN).

研究的目的:

分析肩关节辐射剂量与患者报告的手臂发病率之间的关联.
用SENOMAC数据评估手术后的一年和三年的结果.
为了为肩关节的剂量-体积约束的发展提供信息.

主要方法:

分析了868名瑞典SENOMAC患者 (2015-2019) 的放射治疗计划.
肩关节的定义是使用自动细分的部头与1厘米边缘.
通过淋巴-ICF问卷评估了手臂发病率,重点是功能和移动性.

主要成果:

肩关节的辐射剂量在ALND和SLN组之间是相似的.
在SLN组中,较高的D0.5cc (接近最大剂量) 与3年后更糟糕的手臂发病率相关,特别是在乳腺保护手术后.
在ALND组中没有发现任何关联,也没有确定任何特定的剂量值.

结论:

在最大的肩关节辐射剂量和随后的手臂/肩部副作用之间存在潜在的联系.
在SENOMAC试验中,扩展后续调查将进一步了解长期手臂发病率.
这项研究强调了需要仔细规划放射治疗,以尽量减少乳腺癌患者的肩部发病率.

关键词:

乳腺癌是什么? 乳腺癌是什么?剂量体积的限制.节点辐射疗法节点辐射疗法患者报告的手臂发病率在SENOMAC的试验中.肩膀关节的肩膀关节是什么意思

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