乳腺癌保乳综合治疗的疗效观察

Therapeutic effect of breastconserving surgery and radical breast irradiation

目的：探讨乳腺癌保乳手术加根治性放疗的治疗原则，观察近期疗效。方法：２０例乳腺癌患者施行了肿瘤切除和腋淋巴结清扫术，手术后２～４周接受放疗。外照射用对穿切线野照射全乳腺５０Ｇｙ／５周，瘤床部位组织间插植１９２Ｉｒ针管，一次性放疗８Ｇｙ／１．０～１．５ｃｍ，或用电子束２Ｇｙ／次，共８次。如患者乳房肿瘤位于乳房乳晕区或腋淋巴结阳性，则内乳淋巴结及锁骨区接受放疗。平均随访时间为１４个月。结果：２０例患者全部存活，无１例出现局部复发，无放疗反应，外形满意。只有１例Ｔ４Ｎ１患者在治疗后１８个月出现骨转移。结论：早期乳腺癌患者接受保乳手术加根治性放疗可以取得满意的临床效果。

Objective:To evaluate the treatment principle and the preliminary outcome of breast cancer treated with breastconserving surgery and radical breast irradiation. Methods: Twenty patients with breast cancer were treated with tumorectomy and axillary node dissection followed by radiotherapy 2～4 weeks after the operation. External radiotherapy consisted of 50 Gy delivered to the entire breast via opposing tangential fields over a period of 5 weeks. A boost of 8 Gy with 192Ir interstitial implant or 16 Gy with external electrons at the rate of 2 Gy per day was delivered to the primary site. The ipsilaternal clavical and internal mammary lymph node chain were irradiated in patients with central lesion or with positive axillary lymph nodes. Results: The mean followup was 14 months. All patients were alive without localregional relapse and without any side effects. Only one patient with T4N1 lesion had bone metastasis 18 months after treatment. The cosmetic results was good in all cases. Conclusion: Breastconserving surgery and radical radiotherapy in early stage breast cancer may achieve good clinical results and may be considered as a standard treatment option for early stage breast cancer.