^(125)Ⅰ粒子术中植入在早期乳腺癌患者治疗中的临床价值  

Clinical value of ^(125)Ⅰ particles intraoperative implantation in therapy of early breast cancer patients

作　　者：肖欢[1] 潘卫民[1] 高炳玉[2] 刘玉[2] 孙雯[1] 陈鸿彦[1] 

机构地区：[1]海南医学院附属医院核医学科,海南海口570102 [2]海南医学院附属医院乳腺外科,海南海口570102

出　　处：《中国热带医学》2015年第11期1365-1368,共4页China Tropical Medicine

基　　金：海南省自然科学基金(No.309093)

摘　　要：目的探讨125Ⅰ粒子术中植入在早期乳腺癌患者联合治疗中的临床价值。方法回顾性分析海南医学院附属医院2005年1月—2008年12月53例行保乳手术治疗的乳腺癌患者的临床病理资料,根据125Ⅰ粒子术中植入与否比较无病生存期(Disease-free survival,DFS)和总生存期(Overall survival,OS)。结果 39例女性早期乳腺癌患者均给予保乳术+术中植入125Ⅰ粒子治疗,按照TPS方案,向患侧胸骨旁线的后内侧及胸廓内动脉周围纵行植入一排125Ⅰ粒子(约10余枚)和向腋静脉水平以上至锁骨上下区域植入125Ⅰ粒子(约10余枚)。单因素分析显示125Ⅰ粒子、雌激素受体(ER)、孕激素受体(PR)状态、淋巴结转移率(LNR)、内分泌治疗均与DFS、OS具有相关性(P<0.05),绝经与否(DFS:P=0.060,OS:P=0.031)和化疗方案(DFS:P=0.118,OS:P=0.024)仅与OS具有相关性。多因素分析显示,125Ⅰ粒子、LNR、PR状态仍然是DFS、OS的独立预测指标(P<0.05)。结论 LNR作为一个独立预测指标,可用于评价行保留乳房手术治疗发生淋巴结转移的乳腺癌患者的预后;在LNR≤0.20的患者125Ⅰ粒子术中植入能有效控制乳腺癌术后局部复发,提高了无病生存期率和总生存期率。Objective To discuss clinical value of ^125I particles intraoperative implantation in therapy of early breast cancer patients. Methods Retrospective analysis of 53 patients with breast cancer surgery treatment and routine clinical pathological data obtained from Hainan Medical College affiliated hospital from January 2005 to December 2008 were performed, disease-free survival （DFS） and overall survival（OS） were compared according to whether the intraoperative implantation of ^125I particles or not. Results A total of 39 female cases with early breast cancer were treated with ^125I particles implantation and breast conservative surgery. According to the TPS project, into a row of ^125I particles （more than 10） were implanted to the side near the sternum line after the medial longitudinal around and within the thoracic artery and implanted ^125I particles （more than 10） at the level of axillary vein to collarbone and regional. Univariate analysis showed that the number of ^125I, LNR, estrogen and progesterone receptor status, and hormone therapy were the prognostic factors for DFS and OS （P〈0.05）. The correlation between menopause （DFS ： P=-0.060, OS ： P=-0.031 ） and chemotherapy （DFS ： P=-0.118, OS： P=-0.024） was only related to OS. Multivariate analysis indicated that ^125I, LNR, estrogen and progesterone receptor status were independent prognostic factors of DFS and OS （P〈0.05）. Conclusion LNR is an independent prognostic factor in axillary lymph nodepositive breast cancer patients treated with breast conservation surgery. LNR〈0.20, intraoperative implantion of ^125I can effectively control postoperative local recurrence of breast cancer, and improve the survival rate without disease and overall survival rates.

关 键 词：125Ⅰ粒子 乳腺癌 无病生存期 总生存期 

分 类 号：R732.2[医药卫生—肿瘤]