乳腺癌改良根治术后放疗时机不同疗效对比观察(1)
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【摘要】 目的 研究乳腺癌改良根治术后放疗开始时间不同对总体疗效的影响,探讨乳腺癌改良根治术后放射治疗的最佳时机。方法 选择河南科技大学第一附属医院放疗科2001年4月初至2005年5月末收治乳腺癌改良根治术后、T1-T3，腋下淋巴结大于3枚的放疗患者的临床资料进行回顾性分析。327例患者中219例术5周内接受放疗(治疗组)；108例大于12周后接受术后放疗(对照组),放疗范围为患侧胸壁+同侧腋下(部分)+同侧锁骨上野照射,总剂量为50Gy/25次。比较两组患者3年及5年总生存率、局部控制率和远处转移率。结果 治疗组病例的3年和5年生存率分别为85.7%和71.1%, 5年局部控制率及远处转移 率为97.2%和19.3%。对照组的3年及5年生存率分别为86.3%和69.5%,5年局部控制率及远处转移率为90.3% 和42.1%,差异有统计学意义。结论 乳腺癌局部控制至关重要,局部扩大野放射治疗同时结合全身化疗是降低乳腺癌术后复发及转移的较好模式。
【关键词】 乳腺癌;改良根治术;放疗;化疗
Analysis of Clinical effect of Radiotherapy after modified radical mastectomy
LIJing-xia, MUShuang-feng, QU zhi-feng,et al.
Department of Oncology, First Affiliated Hospital of Henan university of Science and Technology, Luoyang 471003, China
【Abstract】 Objective To study the prognosis-related factors of Radiotherapy after modified radical mastectomy for breast cancerand explore an optimal treatment for local recurrence after modified radical mastectomy for breast cancer. Methods From April 2001 to May 2005,the cases of 327 women patients with T1 to T3 breast cancer with more than three positive lymph nodes after modified radical mastectomy were reviewed, 219 cases were treated with chemotherapy combined with radiotherapy in five weeks after modified radical mastectomy(the treatment group), While 108 cases were treated after 12 weeks(the control group). The ipsilateral chest wall, armpit and supraclavicular fossawere irradiated with doses of 50 Gy in 25 fractions.Results The overall survival rates of 3-,5-year in the treatment group was 85.7%,71.1%. While in the control group it was 86.3%, 69.5%.The 5 year local control and the distant metastasis rate in the treatment group was 97.2%, 19.3% and for the cases of the control group was 90.3%, 42.1%.Conclusion It was an optimal treatment of chemotherapy combined with local extended field radiotherapy, it could cut down recurrence and metastasis.
【Key words】 Breast cancer; Modified radical mastectomy; Radiotherapy; Chemotherapy
在未用全身性辅助治疗的时代，大量临床资料证实，乳腺癌术后放疗可使局部和区域淋巴结复发率降低。EBCTCG1995年对36组随机试验的荟萃分析表明，乳腺癌根治术或改良根治术后放疗使局部和区域淋巴结复发率降低2/3。近年来，随着化疗和内分泌治疗以及单克隆抗体的发展应用的日益广泛。全身治疗不但可以提高总生存率，还能一定程度降低局部和区域淋巴结复发率 ......
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