乳腺癌根治术后放射治疗胸壁及腋窝的临床意义  

Clinical significance of postmastectomy radiotherapy to chest wall and armpit in breast cancer

作　　者：翟忠舟 赛亚非 樊彩霞[1] 焦建峰[1] 乔万海[1] 

机构地区：[1]包头市第七医院放疗科,内蒙古包头014030

出　　处：《现代肿瘤医学》2004年第3期215-217,共3页Journal of Modern Oncology

摘　　要：目的　探讨乳腺癌根治术后放射治疗胸壁、腋窝的临床意义。方法　资料完整 ,经过随访病例 14 6例 ,其中ⅡA4 7例 ,Ⅱb5 3例 ,ⅢA38例 ,Ⅲb8例。合并胸壁放疗组 4 6例 (胸壁组 ) ;放疗锁骨上区、内乳区 5 0例(2野组 ) :放疗锁骨上区、内乳区及腋窝 5 0例 (3野组 )。每野照射剂量 5 0 - 5 5GY ,5 0～ 5 6周完成。结果　1、3、5年局部控制率 (包括胸壁、锁骨上区、内乳区腋窝 ) ,胸壁组分别为 98 0 %、95 5 %、95 5 % ;2野组分别为 87 8%、82 4 %、79 4 % ,3野组分别为 91 5 %、84 2 %、80 8%。胸壁组与 2野组比 χ2 =4 5 2 4 (P <0 0 5 ) ;胸壁组与 3野组与 χ2 =3.4 86 (P =0 .0 5 6 )。胸壁复发率 :胸壁组为 2 2 % ,未照射胸壁 (2野组 +3野组 )者为13% ,χ2 =4 2 5 9(P <0 0 5 )。腋窝复发率 :2野组不照射腋窝 ,3野组照射腋窝 ,复发各为 8%、2 % ,(P >0 0 0 5 ) ,患侧上肢水肿发生率各为 14 %、38% ,(P <0 0 1)。 1、3、5年生存率 ,胸壁组分别为 97 8%、85 1%及80 3% ;2野组分别为 95 1%、83 4 %及 71 7% ;3野组分别为 93 8%、82 9%及 6 5 7%。胸壁组与 2野组、3野组相比 ,P均 >0 0 5。远处转移 ,胸壁组 10 8% ,2野组 8 0 % ,3野组 10 % ,P均 >0 0 5。结论　胸壁放射治疗 。Objective To evaluate chinical significance of postmastectomy radiotherapy to chest well and armpit in breast cancer.Methods Complete data was obtained by visiting 146 patients including Ⅱ A period 46 cases,Ⅱ b period 53 cases,Ⅲ A period 39 cases,Ⅲ b period 8 cases.Among these patients,46 received chest wall irradiation(chest-wall-group),50 received top area of clavicle and the interior area of breast irradiation(2-fields-group),50 received top area of clavicle,interior area of breast and armpit(3-fields-group).Each fields use a does of between 50-55Gy,accomplished between 5.0～5.6 weeks.Results The 1-year,2-year and 3-year regional control rates were 98.0%,95.5%,95.5% in all patients for chest-wall-group;87.0%,82.4%,79.4%for two-fields-group;91.5%,84.2%,80.8% for three-fields-group.Clest-wall-group and two-fields-group χ2=4.524,P<0.05.Chest-wall-group and 3-fields-group,P=0.056.Chest wall recurrence rates were 2.2% for the chest-wall irradiated group,13%,P<0.05 for the chest-wall-unirradiated group.(2-fields-group and 3-fields-group).Armpit recurrence rates were 8% and 2%,P>0.05.Dropsy rates in arms were 14%,38%,P<0.01 for above two groups.The 1-year,3-year and 5-year survival rates were 97.8%,85.1%,80.3% and 95.9%,83.4%,71.1% and 93.8%,82.9,65.7% in all patients for three groups.χ2=0.135 for the chest-wall-group,χ2=1.496 for both the two and the three and P>0.05 is for all of them.On distant metastasis of the carcinoma,it is 10.8% with χ2=0.23,8% and 10% with χ2=0.019 for 1-group,2-group and 3-group;P>0.05 for both Group 2 and Group 3.Conclusion By chest wall irradiation,regional controlling rates can be greatly improved and locoregional recurrence is reduced.However,survival rate is not improved.

关 键 词：乳腺肿瘤 放射治疗 术后 

分 类 号：R737.9[医药卫生—肿瘤]