1999-2008年中国大陆地区乳腺癌保乳术及术后放疗情况的临床流行病学研究  

Status of breast conservative therapy for breast cancer in China between 1999 and 2008： an epidemiological study

作　　者：王淑莲[1] 李晔雄[1] 张保宁[2] 宋清坤[3] 李静[3] 范金虎[3] 张斌[4] 杨红健[5] 谢小明[6] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院肿瘤研究所放疗科,100021 [2]北京协和医学院中国医学科学院肿瘤医院乳腺外科,100021 [3]北京协和医学院中国医学科学院肿瘤医院流行病室,100021 [4]辽宁省肿瘤医院乳腺外科 [5]浙江省肿瘤医院乳腺外科 [6]中山大学附属肿瘤医院乳腺科

出　　处：《中华放射肿瘤学杂志》2013年第6期427-431,共5页Chinese Journal of Radiation Oncology

摘　　要：目的 了解中国大陆地区乳腺癌保乳治疗和放疗情况.方法 随机纳入7家医院在1999-2008年治疗的乳腺癌患者,分析其中230例保乳治疗者的一般临床病理因素和检查治疗情况,及术后放疗使用及部位情况.对结果采用Wilcoxon分析、Cochran-Armitage趋势检验和x2检验等.结果 198例（86.1％）接受腋窝淋巴结清扫术,16例（7.0％）行前哨淋巴结活检术,15例（6.5％）未行腋窝手术,1例不详（0.4％）.165例（71.7％）接受术后放疗,术后放疗的使用率随不同治疗年代变化不明显（P=0.212）,不同医院之间有差别（P =0.000）.全乳放疗后134例（81.2％）瘤床补量.除导管内癌患者,152例放疗者中31.6％照射同侧锁骨上下区、7.9％照射同侧腋窝、5.3％照射同侧内乳.腋窝淋巴结阳性数为0、1～3和≥4个者接受锁骨上下区照射的比例分别为31.5％、54.2％和100％ （P =0.000）.结论 国内地区乳腺癌保乳术的开展有待于进一步提高,前哨淋巴结活检的使用率低.保乳术后放疗范围选择较规范,但使用率需要提高.Objective To investigate the status of breast conservative therapy for breast cancer in China's Mainland.Methods A multi-center retrospective epidemiological study was undertaken.Patients with breast cancer treated between 1999 and 2008 were randomly selected from seven hospitals.230 patients treated with breast conservative therapy were included for this analysis.Information on patients＇ characteristics,pathology and treatment were collected and analyzed.The use of postoperative radiotherapy （RT） and radiation targets were analyzed.Wilcoxon analysis,Cochran-Armitage trend test and the chisquare test were used to compare differences.Results The median age of the patients was 43 years （range,23-85）.198（86.1%） patients received axillary dissection,16（7.0%） sentinel lymph node biopsy and 15（6.5%） patients didn＇t have axillary operation,1 （0.4%） unknown.Of 164（71.3%） patients who had frozen section analysis for intraoperative margin assessment,17 （10.4%） had positive margin and underwent 31 subsequent re-excision.One patient had positive margin on final analysis after surgery.165 （71.7%） patients received RT.From 1999 to 2008,there was no significant change in the use of RT （P =0.212）.However,there were significant regional differences in the use of RT （P =0.000）.134（81.2%） patients received tumor bed boost after whole breast radiation.Of 152 patients with RT （excluding patients with ductal carcinoma in situ）,48 （31.6%）,12 （7.9%） and 8 （5.3%） had received RT in supraclavicular fossa （SCF）,axilla and internal mammary chain,respectively.The use of SCF RT was 31.5% （28/89）,54.2% （13/24） and 100% （7/7） for patients with 0,1-3 and ≥4 positive axillary nodes （P =0.000）.Conclusions The use of breast conservative surgery and sentinel node biopsy is quite low in the treatment of early breast cancer patients in China's Mainland.Radiotherapy after breast-conserving surgery ranges are relatively specification.The use of radiotherapy after b

关 键 词：乳腺肿瘤 保乳术 乳腺肿瘤 放射疗法 流行病学研究 

分 类 号：R737.9[医药卫生—肿瘤]