保守性手术加放疗治疗早期乳腺癌的10年疗效

Ten-Year Results of Conservative Surgery with Adjuvant Radiotherapy for Early Stage Breast Cancer.

目的：回顾性分析保守性手术加放疗（ＣＳＲＴ）治疗早期乳腺癌的远期效果。方法：１９８７年１０月～１９９１年１月，４０例早期乳腺癌采用ＣＳＲＴ。Ｉ期２０例，Ⅱ期１９例（Ｔ２Ｎ０１３例，Ｔ１Ｎ１２例，Ｔ２Ｎ１４例），导管内癌１例。肿瘤大小０．９～４．４ｃｍ，３６例肿块直径≤３ｃｍ。手术范围包括：乳房象限切除和腋窝下、中群淋巴结清除术，术后切线野照射全乳房，淋巴结阳性者加照内乳和锁骨区。对＞１ｃｍ的浸润性癌，用ＣＭＦ方案辅助化疗。结果：本组１０年总生存率和无病生存率９２．５％，保留乳房美观效果优良率８６．５％，局部复发率７．５％。结论：对早期乳腺癌，如病例选择适当，在具有良好的外科手术和放疗技术的单位，采用ＣＳＲＴ可取得长期满意的肿瘤局部控制和良好的乳房美观效果。

Objective: To analyze the long-term results of conservative surgery with adjuvant radiotherapy (CSRT) for early breast cancer. Methods: From October 1987 to January 1991, 40 patients with early breast cancer were treated by CSRT. Of them, 20 patients were in stage I,19 in stage Ⅱ (T2N0 13 cases, T1N1 2 cases and T2N1 4 cases)and one with intraductal carcinoma. Tumor size ranged from 0.9cm to 4.0 cm, and 36 patients had tumor size less than 3cm. Quadrantectomy, axillary nodes dissection of level Ⅰ and Ⅱ, and post-operative radiotherapy was performed to the whole group. The internal mammary re- gion and supraclavicular area were irradiated in patients with node metastases. Patients with tumors > 1cm received chemotherapy by using CMF regimen. Results: Both 10-year overall survival rate and disease-free survival rate were 92.5%. Three of 40 patients(7.5%) had local recurrence. The cosmetic results of the breast were excellent or good in 86.5% of patients. Conclusions: CSRT could provides long-term local tumor control and satisfying cosmetic results for early stage breast cancer.