40例早期乳癌保乳术后放射治疗的临床观察

Clinical Observation of Early Breast Cancer after Breast Conserving Surgery and Radiotherapy for 40 Patients

目的：观察早期乳腺癌保乳手术后放射治疗的疗效、美容效果及并发症。方法：对40例早期乳腺癌患者行保乳手术，术后联合放射治疗，采用全乳切线野照射50Gy／25Fx，后瘤床补量14or／7Fx。腋窝淋巴结阳性者，患侧锁骨上x线和电子线混合照射50G弘结果：随访12～62个月，1年生存率100％，3年生存率95％，5年生存率92．5％。近期美容效果患者自评满意度佳、良者92．5％。无局部复发。3例远处转移，3例放射性肺炎，9例急性放射性皮肤反应，无Ⅲ-Ⅳ度骨髓抑制。结论：放射治疗可使早期乳腺癌保乳患者术后获得满意的生存率和美容效果，提高了患者的生活质量。

Objective： To observe the outcome, cosmetic effect, and toxicity of breast-conserving surgery with postoperative radiotherapy for early stage of breast cancer patients. Method： Forty patients with early stage of breast cancer received combination of breast-conserving surgery with postoperative radiotherapy. Tangential irradiation was used with a dose of 50 Gy/25 Fx, Tumor bed received a boost dose 14 Gy/7 Fx electron beam. For axillary lymph node-positive patients, ipsilateral supraclavicular field was hybrid irradiated with 50 Gy X and electron beam. Result： The total follow- up ranged from 12 to 62 months, 1-year, 3-year and 5-year survival rates were 100%, 95% and 92.5%. Cosmetic result scored as good was 92.5%. No local recurrence was found, distant metastasis happened in three cases. Three cases appeared radiation-induced pneumonitis and nine cases appeared radiation-induced dermatitis. Conclusion： Satisfactory life quality and local control can be obtained in early breast cancer patients with breast conserving therapy and postoperative radiotherapy.