摘要
前哨淋巴结阳性患者的常规处理是进一步行腋窝淋巴结清扫,但腋窝淋巴结清扫会带来血清肿、上肢功能障碍、水肿等并发症。Z0011、IBCSG 23-01和AMAROS的Ⅲ期随机对照临床研究探索均为在临床N0期患者中安全减免前哨淋巴结活检阳性后的腋窝淋巴结清扫,为这部分患者的腋窝处理提供了新选择,但也给辅助放疗决策带来了新问题。本文将主要基于上述三项临床研究和腋窝淋巴结转移复发风险相关最新文献,针对包括手术和辅助放疗在内的低负荷前哨淋巴结阳性患者腋窝处理策略进行综述。
For patients with positive sentinel lymph nodes, axillary lymph node dissection （ALND） is the conventional treatment. However, ALND can cause seroma, the upper limb dysfunction, edema and alternative complications. Z0011, IBCSG 23-01 and AMAROS phase Ⅲ randomized controlled clinical trials recommend ALND after sentinel lymph node biopsy in N0 patients, which provides a novel option for axillary lymph node treatment, but also brings new challenges to the decision of adjuvant radiotherapy. In this paper, based upon these three clinical trials and latest literatures related to the risk of axillary lymph node metastasis and recurrence, the therapeutic strategies including surgery and adjuvant radiotherapy for patients with positive sentinel lymph nodes are reviewed and summarized.
作者
曹璐
陈佳艺
Cao Lu;Chen Jiayi(Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, Chin)
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2018年第6期612-615,共4页
Chinese Journal of Radiation Oncology
基金
国家自然科学基金资助（81172504、81673102、81602791）
国家重点研发计划资助（2016YFC0105409）
上海市卫生和计划生育委员会科研课题青年项目基金资助（20164Y0066）
