乳腺癌保留乳房治疗10a疗效分析  

BREAST CONSERVED THERAPY FOR BREAST CANCER

作　　者：刘岩松[1] 于金明[1] 王永胜[1] 左文述[1] 于志勇[1] 项宇峰[1] 彭佐良[1] 李祖国[1] 

机构地区：[1]山东省肿瘤医院乳腺病中心,山东济南250117

出　　处：《肿瘤研究与临床》2004年第2期107-109,共3页Cancer Research and Clinic

摘　　要：目的:研究评价保乳治疗的效果,分析1985年—1995年111例在该院行保乳治疗患者的远期疗效。方法:111例临床Ⅰ期、Ⅱ期患者行保乳手术,术后行全乳放疗,局部缩野照射。用SAS软件分析患者年龄,肿瘤大小,组织学类型,切缘,淋巴结转移,术后放疗与复发的关系,分析切除组织量与复发率和美容效果的关系。结果:中位随访10 a,10 a复发率10 % ,转移率27 %,生存率81 %。年龄、组织学类型、淋巴结转移与复发无显著性关系(P >0.05)。肿瘤大小,切缘情况与复发有关(P <0.01)。术后未行放疗的复发率高,达75 %。60Co放疗复发率高于加速器(11 % vs 5 %)。单纯局部复发与转移无明显相关性(P >0.05)。行象限切除复发率不低于肿瘤扩大切除(P >0.05),但明显影响美容效果。结论:保乳治疗适合不同年龄、不同组织学类型的早期乳腺癌,在保证切缘阴性的前提下,扩大切除范围不提高疗效反而会影响美容效果。放疗技术的提高有助于减少复发。Objective: The present study reviews long- term outcome of 111 patients after breast conserved therapy from 1985 to 1995 in Breast Center of Shandong Cancer Hospital and Institute. Methods: 111 patients with stage Ⅰor Ⅱ breast cancer were treated with conservative surgery and breast radiation therapy, boosts were given at the primary tumor site. Use SAS software to evaluate the relation of recurrence with age, tumor size, tumor histology, margin status, N stage and radiation therapy. The relation of the extension of excision with the recurrence rate and esthetics effect was evaluated. Results: The median follow- up for all patients is 10 years, the 10- year recurrence rate is 10 %, distant metastasis rate is 27 %, survival rate is 81 %. Age,tumor histology,N stage don't not influence local recurrence(P>0.05). Tumor size and margin status are related to the recurrence(P<0.01).Patients who refuse to undergo radiation therapy have high recurrence rate of 75 %. The progress of radiation technique can reduce the recurrence rate(11 % vs 5 %). Local recurrence have no relation with distant metastasis(P>0.05). Extension of excision have no relation with local recurrence(P>0.05), but destroy the esthetics effect. Conclusion: Breast conservation therapy suits for each age and histology of early stage breast cancer. To confirm the negative margin, extend the excision extension have no help to improve the curative effect but to decrease esthetics effect. The progress of radiation technique can reduce the recurrence.

关 键 词：乳腺癌 保乳治疗 局部复发 

分 类 号：R737.9[医药卫生—肿瘤] R730.56[医药卫生—临床医学]