摘要
目的:通过对早期乳腺癌保乳术后放射治疗的研究,探讨其远期疗效及瘤床加量照射和放化疗顺序等问题。方法:84例早期乳腺癌患者行保乳手术,术后行三维适形放疗,50Gy/25次,1次/天,5次/周,瘤床局部加量10～16Gy/5～8次。化疗采用蒽环类为主的方案,65例肿瘤直径>1cm者先化疗3个周期后放疗,然后再化疗1～3周期,13例肿瘤直径≤1cm者在术后3～6周放疗,然后化疗4～6个周期。ER/PR阳性者均行内分泌治疗。结果:全组病人5年生存率100%,5年无瘤生存率91.4%。3例乳腺局部复发,3例分别出现肺、肝和骨转移,其中2例死于肿瘤转移。总复发率7.1%。瘤床加量组局部复发率低于未加量组(P=0.04)。放化疗顺序对肿瘤复发率无影响(P=0.15)。美容效果优良率94%,一般者3.6%,差者2.4%。结论:放射治疗是早期乳腺癌保乳治疗的重要组成部分,瘤床加量照射可降低局部复发率。放化疗顺序对于局部复发率影响不大。
Objective： To investigate the late effect of breast-conservlng surgery plus radiotherapy on early breast cancer （EBC） and the supplementary dose of radiation to tumor beds and the sequences of chemoradiotherapy. Methods： 84 patients with EBC were done breast-conserving surgery. After operation, all the patients were received three-dimensional conformal radiotherapy （50 Gy twenty-five times, once a day, five times a week） and the supplementary dose of radiation to parts of tumor beds （10-16Gy, 5-8 times）. All the patients were given anthracycline-based chemotherapy and hormonotherapy according to the patients ER/PR receptor status. Survival was calculated by Kaplan-Meier method. The difference between local recurrence rates of different therapeutic groups was evaluated by χ^2 test. Results： Among the patients, -year survival rate was 100%; 5-year survival rate without tumor was 91.4%; 3 cases of parts of of mammary glands recurred （total recurrence rate,7.1%）; The local relapse rate of the group with additional radiotherapy was lower than that without boost irradiation （P=0.04）. The sequences of radiotherapy and systemic therapy had no influence on the recurrence rate （P=0.15）. The cosmetic excellent rate was 94O/o. Conclusions： Radiotherapy is an important part in breast-conserving surgery for EBC. the supplementary dose of radiation to tumor beds can reduce local recurrence, on which, chemoradiotherapy has not significant influence.
出处
《现代生物医学进展》
CAS
2007年第8期1187-1189,共3页
Progress in Modern Biomedicine
关键词
乳腺肿瘤/外科学
乳腺肿瘤/放化疗法
推量照射
预后
Breast neoplasms/sugery
Breast neoplasms/chemoradiotherapy
Radiotherapy boost
Prognosis
