放射治疗在早期乳腺癌保乳术中的价值  

Value of radiotherapy following breast-conserving surgery in early stage breast cancer

作　　者：李文如[1] 陈刚[1] 汪忠[1] 向毅晖[1] 倪旭东[2] 张勇[3] 许厚顺[2] 杨永康[2] 

机构地区：[1]复旦大学附属中山医院分部放疗科,上海200052 [2]复旦大学附属中山医院分部外科,上海200052 [3]复旦大学附属中山医院分部放外科,上海200052

出　　处：《中国癌症杂志》2004年第1期75-77,共3页China Oncology

摘　　要：目的 :进一步证实放射治疗在早期乳腺癌保乳术中的重要性。方法 :1994年 12月～ 2 0 0 1年 12月本院共收治 2 3 7例早期乳腺癌。其中 83例做保乳手术。 154例做改良根治术。保乳术后全部患者接受放疗。放疗的范围根据肿块的大小、部位、腋淋巴结是否受累而定。胸壁切线剂量予 8MV X线 50 0 0cGy。肿瘤瘤床加电子线 150 0cGy。改良根治术后仅 3例作放疗。 结果 :保乳组和改良组局部复发各 1人。保乳组区域淋巴结复发 1例。改良组无区域淋巴结复发 ,有肝转移、肺转移各 1人。两组各死亡 1人。保乳组五年生存率 96.49% ,改良组98.61%。保乳组双侧乳房外形基本一致 ,柔软 ,有弹性。结论 :早期乳腺癌保乳术加放射治疗 ,效果与改良根治术相似 。Purpose:To validate further the importance of r adiotherapy following breast-conserving surgery in early breast cancer. Methods:From 1994.12 to 2001.12,237patients with early stage breast can cer were treated Of these patients,eighty-three received breast-conserving surgery followed by radiotherapy,and one hundred and fifty-four received modified radical mastectom y.All patients with breast-conserving surgery underwent postoperative radiother apy.The range of radiation dose depends on the size,location of tumor,and involv ement of axillaty nodes.Tangential chest wall fields delivered 5000cGy with 8MV -X ray beam in 5 weeks .An additional 1500cGy was delivered in 8 days to tumor bed with electron beam.Among the patients with modified radical mastectomy.only 3 received postoperative radiotherapy.Results:In both the breast-conserving surgery group and modified radical mastectomy gro up,one patient recurred regionally,and one died respectively .In the modified ra dical mastectomy group,there were no regional lymph nodes recurrence,but two of them had distant metastasis.The 5year survival of the two groups were 96.49%and 98.61%,respectively.The breasts are soft and resilient in the breast-conserving surgery group,and breast shape whole after surgery.Conclusions :Breast-conserving surgery plus postoperative radiotherapy in early breast can cer can obtain treatment results similar to modified radical mastectomy,with goo d cosmetic

关 键 词：早期乳腺癌 保乳手术 放射治疗 

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