乳腺癌乳房切除术后放射治疗的疗效分析
Efficacy of the Radiotherapy after Mastectomy in Breast Cancer
作者: 李云海 * , 王月琴 , 蒋 娉 , 沈海英 , 沈琰琦 , 李永春 , 夏 怡 , 罗伟明 , 朱 虹 , 肖 锋 :复旦大学附属肿瘤医院闵行分院放疗科,上海; 李 纲 :复旦大学附属肿瘤医院闵行分院化疗科,上海; 李 雷 :复旦大学附属肿瘤医院闵行分院乳腺外科,上海;
关键词: 乳腺肿瘤/外科学; 乳腺肿瘤/放射治疗; 预后; Breast Neoplasms/Surgery; Breast Neoplasms/Radiotherapy; The Prognosis
摘要:Abstract: Objective: To summarize the outcome of radiotherapy in breast cancer after mastectomy, and to explore the relevant prognostic factors. Material and Methods: From January 2005 to December 2012, a total of 241 women who had undergone mastectomy were analyzed. The median age was 51 years old, with minimum 27 years old and maximum 75 years old. The pathological stage 0 were 1 case, IA of 11 cases, IIA of 51 cases, IIB of 41 cases, IIIA of 82 cases, IIIB of 3 cases, IIIC of 42 cases, IV of 10 cases, which performed in all patients by using AJCC 7th. All patients underwent mastectomy, which 210 cases of modified radical mastectomy, 29 cases of radical mastectomy, and 2 cases of extended radical mastectomy. In addition to three cases were unknown, the remaining patients received postoperative chemotherapy, while 50 patients received neoadjuvant chemotherapy. All patients were treated with radiation therapy, the median dose 50 Gy (30 - 60 Gy), irradiated sites included ipsilateral chest wall, lymph drainage area (supraclavicular and/or internal mammary). 147 cases were treated with chest wall, ipsilateral supraclavicular and internal mammary nodes irradiation (61.0%), 47 cases were treated with chest wall and supraclavicular irradiation (19.5%), 39 cases were treated with non-irradiated chest wall, only supraclavicular and/or internal mammary nodes (16.2%), 6 cases were only irradiated to chest wall (2.5%), two cases to chest wall and internal mammary irradiation (0.8%). Results: The median follow-up was 5.5 years (0 - 10 years), the 5-year OS was 87.5%. Univariate analysis showed that tumor stage was an important factor affecting the OS, 5-year OS of the pathological stage I and II was 95.9% while the OS of stage III and IV was 81.0% (P = 0.002). LRR in 14 cases (5.8%), whereas DM was the main causes of failure, which included 49 cases (20.3%). 36 patients died, all died of cancer. Conclusions Only 5.8% patients have locoregional recurrence, suggesting that radiation therapy after mastectomy is still the standard treatment in breast cancer. 5-year OS is approaching the world advanced level.
文章引用: 李云海 , 王月琴 , 蒋 娉 , 沈海英 , 沈琰琦 , 李永春 , 夏 怡 , 罗伟明 , 朱 虹 , 肖 锋 , 李 纲 , 李 雷 (2016) 乳腺癌乳房切除术后放射治疗的疗效分析。 世界肿瘤研究, 6, 8-13. doi: 10.12677/WJCR.2016.61002
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