乳腺癌胸壁复发的后装敷贴近距离放射治疗

Mould Brachyradiotherapy for Recurrence of Breast Cancer on Chest Wall

目的 探讨乳腺癌胸壁敷贴近距离放射治疗的临床价值。方法 采用胸壁敷贴近距离放射治疗乳腺癌胸壁大面积复发且经化疗及内分泌治疗后效果欠佳的患者30例。外照射总剂量为DT 50Gy/25次,5周,然后再用胸壁后装敷贴近距离放射治疗DT 20～30 Gy,每次250 cGy,2次/d。部分单纯后装敷贴近距离放射治疗,每次250 cGy,2次/d,DT 30～40 Gy。结果 CR 20例,PR 5例,NC 3例,PD 2例,有效率83.33%（25/30）。1年生存率52%、2和3年生存率26%。局部达全部消退的生存优于残留和进展（2χ=4.35,P〈0.05）。复发距第1次放疗间隔时间、首次原病灶分期、照射总量与敷贴后生存无明显关系。未发现严重毒副反应。结论 敷贴近距离放射治疗乳腺癌胸壁大面积复发是一种局控率高,无严重毒副反应的有效方法。

Objective To estimate the value of mould brachyradiotherapy for recurrence of breast cancer on chest wall. Methods We applied mould brachyradiotherapy to treat 30 patients with the recurrence of breast cancer on chest wall, who failed after chemotherapy and endocrine therapy. After external irradiation for DT 50 Gy/25 F,5 weeks, patients were received mould brachyradiotherapy DT 20 -30 Gy, 250 cGy/F and twice every day. Some patients were received only mould brachyradiotherapy DT 30 -40 Gy, 250 cGy/F and twice every day. Results CR was 20 cases,PR 5 cases,NC 3 cases,PD 2 cases, objective response was 83.33% （25/30）. 1 year survival rate was 52% , 2 and 3 year survival rate was 26%. The survival rate was better in patients without rudimental tumor than that in patients with rudimental tumor （χ^2 = 4. 35, P 〈 0.05）. There was not any serious complication. Conclusions Mould brachyradiotherapy was a feasible and effective method to treat the recurrence of breast cancer on chest wall. It has higher local control rate and without serious complication.