早期乳腺癌保存乳房治疗不同补量照射方式的比较  

Comparison of Results with Two Different Tumor Bed Boost Irradiations in The Conservative Therapy with Breast Preservation for Early Breast Cancer

作　　者：李健 张秀萍 万跃[2] 杨家祥[2] 刘晓渝[2] 彭玉梅[2] 

机构地区：[1]广州市肿瘤医院,广东广州510095 [2]重庆市肿瘤医院,重庆400030

出　　处：《中国肿瘤》2003年第3期164-166,共3页China Cancer

摘　　要：[目的]比较早期乳腺癌保留乳房治疗中两种不同照射补量方式对患者生存率和美容效果的影响。[方法]回顾性分析了1990年3月到1996年5月共51例Ⅰ～Ⅱ期乳腺癌患者行保留乳房治疗的病例。A组:近距离插植照射补量组;B组:外照射补量组。A组平均年龄45.7岁,B组平均年龄44.3岁。病例分期:A组Ⅰ期7例,Ⅱ期13例;B组Ⅰ期12例,Ⅱ期19例。全部患者均接受肿瘤局部切除术+同侧腋窝淋巴结清扫术,随后行乳房两切线野照46Gy/23次,共31天。在近距离插植照射治疗组,瘤床采用铱192高剂量率后装插植治疗14Gy～20Gy,分1～3次完成。外照射组,采用9～17MeV电子束行瘤床局部照射,剂量为(18～20)Gy/(9～10)次。患者随访5年以上。[结果]5年生存率A、B两组分别为90.00%和87.09%(P>0.05)。两组患者在乳房美容效果方面有差别(P<0.05)。其中近距离治疗组优良率(优秀+良好)为60%(12/20),而外照射组优良率为87.1%(27/31)。[结论]在乳腺癌保乳术后治疗中,两种补量方法在生存率方面差别无显著性。而外照射补量方法在美容效果上优于近距离后装插植治疗补量方法。To compare the survival rates and the cosmetic outcomes of conservative treatment of breast cancer using two different boost irradiations.51patients with early breast cancer treated by conservative surgery+radiation therapy from March1990to May1996were analysed retrospectively.Among the cases,there were20cases with brachytherapy boost irra-diation(group A),31cases with electron beam boost irradiation(group B).The average age was45.7years in group A,44.3years in group B.In group A,7cases were StageⅠ;13cases StageⅡand in group B,12cases were StageⅠ;19cases StageⅡ.All the pa-tients received external irradiation46Gy/23F/31D in the whole breast with two tangential fields following tumorectomy+axillary lymph node dissection.In group A,Iridium192HDR implants was used for tumor bed boost irradiation(14~20)Gy/(1~3)F.In group B,the boost was given(18~20)Gy/(9~10)F/(11~12)D by(9~17)MeV electron beam.The patients were followed up periodically over5years after therapy.Five-year survival rate was90.00%in group A,87.09%in group B(P>0.05).The cosmetic outcomes were different between the groups,in which,the excellent-good rate was60.0%(12/20)in group A;87.1%(27/31)in group B(P<0.05).[Conclusions]Two groups have no difference in five-year survival rate.In cosmetic results,the electron beam boost irradiation is better than that using Iridium192HDR brachytherapy implant.

关 键 词：乳腺肿瘤 放射疗法 补量照射 美容效果 

分 类 号：R737.9[医药卫生—肿瘤] R730.55[医药卫生—临床医学]