Ⅱ期乳癌术后胸壁电子束弧形照射临床观察  

Postmastectomy Electron-beam-rotation Irradiation in Stage ⅡBreast Cancer

作　　者：王迎选[1] 刚颖[1] 吴殿久[1] 何昌秀[1] 崔书祥[1] 王所亭[1] 

机构地区：[1]解放军总医院放射治疗科,北京100853

出　　处：《肿瘤防治研究》2006年第1期54-56,共3页Cancer Research on Prevention and Treatment

摘　　要：目的分析应用电子束弧形照射技术对Ⅱ期乳癌根治术后放疗的临床效果。方法对87例接受了乳癌改良根治术后的Ⅱ期患者实施了术后放疗。靶区为患侧锁骨上、下淋巴引流区、腋窝、胸壁(包括手术疤痕),肿瘤位于内侧象限者,加以内乳区照射。内乳区、胸壁采用电子束弧形照射。结果全组病例5年存活率为79.5%,5年无瘤存活率为76.4%,腋窝淋巴结阳性率<20%组5年生存率为84.8%;>20%组为73.1%(P<0.001)。结论①实施根据胸廓外型和靶区深度调整并转换电子束能量的弧形照射,可以得到理想的靶区剂量分布,改善放疗效果,提高乳癌病人的局部肿瘤控制率,从而改善存活率及生存质量。②腋窝淋巴结阳性率>20%提示预后较差,对此组病例应予以积极的综合治疗。Objective We review the results with the electron-beam-rotation technique in stage Ⅱ locally advanced breast cancer patients. Methods From 1993 to 2001,87 patients with stage Ⅱ locally advanced breast cancer underwent electron beam rotation irradiation of the chest wall and internal mammary lymph nodes with daily fractions of 200cGy per day to 40～50 Gy total dose after modified radical mastectomy and axillary lymph node dissection. Results After a median follow-up of 44 months, the 5-year overall survival was 79. 5 %, disease-free survival was 76. 4% （Kaplen-Meier analysis）. Significant predictors of poor local tumor control was involved axillary lymph nodes）20%, the 5 year overall survival was 73.1% vs 84. 8% with involved axillary lymph nodes（20% （P〈0. 001）. Conclusion ①In high-risk breast cancer patients of postmastectomy, irradiation with the electron beam rotation technique would obtaind optimal radiation dose distribution, it is an effective therapy resulting in a 5 year local（chest wall） failure rate of 6% and subsequently improve the survival rate and qulity of life. ②For the patient with involved axillary lymph nodes）20%, intensified local therapy and combined treatment measurment needs further investigation.

关 键 词：乳腺癌 术后放疗 电子束弧形照射 

分 类 号：R730.55[医药卫生—肿瘤]