摘要
目的:探讨乳腺癌术后局部区域复发的规律和再放疗的预后。方法:回顾分析45例Ⅰ期、Ⅱ期乳腺癌术后局部区域复发的情况以及复发后放疗的预后。26例采用局部野放疗,19例采用扩大野放疗。结果:T2及腋窝淋巴结转移数≥4枚或≥20 %的病例占复发病例的73 %。复发的部位依次为锁骨上、多部位、胸壁、腋窝、内乳。复发后2 a生存率40 %、无瘤生存率24.4 %,2次局部区域复发率31 %,术后2 a以上复发的2 a生存率64 %,2 a以下29 %。首次复发累及多部位生存率18.2 %,较单一锁骨上(47.4 %)及胸壁(30 %)低,累及锁骨上局部复发率高于胸壁,远处转移率低于胸壁,2次局部复发胸壁最高达57 %,照射野采用广泛野的局部复发率低于采用局部野。结论:对Ⅰ期、Ⅱ期乳腺癌中腋窝淋巴结阳性≥4枚或≥20 %的病例应常规行术后放疗,对术后局部区域复发的病例应采用包括胸壁及锁骨上下大范围照射。
Objective: To determine the routine and prognosis of postmastectomy loco- regional recurrence of breast cancer. Methods: From 1992 to 1998,45 patients with stage Ⅰ and Ⅱ breast cancer of postmastectomy loco- regional were treated by radiotherapy in our hospital. The large size field were 19 patients,the loco- regional field were 26 patients. Results: The incidence of patients with 4 (or20 %) or more positive axillary lymph nodes and stage T2 were with recurred rates of 73 %(33/45).The positions of recurrence were supraclavicular nodes in 19 patients,multiple- place in 11 patients,chest wall in 10 patients,axillary lymph nodes in 4 patients, internal mammary lymph nodes in 1 patients.The 2 year survival rates in the recurrent patient were 40 %(18/45).The disease- free survival rates were 24.2 %(11/45).The recurrence rates after loco- regional recurrence were 31 %(14/45).The over 2 year recurrence postomastectomy for 2 year survival rates were 64 %(9/14).Those below 2- year were 29 %(9/31).The 2- year survival rates were of recurrence involving in multiple- place,supraclavicular positive lymph nodes and chest wall were 18.2 %,47.4 % and 30 % respectively.The loco- regional recurrence rates in patients with supraclavicular nodes recurrence were higher than those with chest wall recurrence.The distant metastasis rates were lower than the chest wall(P>0.05).The recurrence rates after loco- regional recurrence on chest wall were 57 %(8/14).It was the highest.The loco- recurrence rates of large size field were 10.5 %(2/19) and loco- regional field were 46 %(12/26)(P>0.05).Conclusion: Radiation therapy should be routinely given to stage Ⅰ and Ⅱ breast cancer patients with four or 20 % or more positive axillary lymph nodes.We suggested that the field of irradiation should involve chest wall and supraclaricular to those patients with loco- regional recurrence.
出处
《肿瘤研究与临床》
CAS
2004年第2期113-115,共3页
Cancer Research and Clinic
关键词
乳腺肿瘤/复发
放射疗法
生存率
Breast neoplasms/recurrence
Radiotherapy
Survival rates
