乳腺癌保乳手术术中射频治疗的临床疗效

Effects of breast-conservative surgery combined with intra-operative radiofrequency ablation in breast cancer

目的：比较单纯行乳腺癌保乳术与乳腺癌保乳术合并术中射频治疗（RFA）的治疗效果。方法：对2009年6月~2012年6月收治的符合保乳条件的345例0~Ⅲa期乳腺癌患者进行保乳手术,其中98例行术中射频治疗（RFA组）,247例未行术中射频治疗（对照组）。比较2组的术后并发症、局部复发率、远处转移率、病死率、乳腺外观的差异。结果：RFA组随访患者90例,中位随访时间36个月,局部复发率2.2%,远处转移率7.7%,病死率3.3%;对照组随访患者219例,中位随访时间33个月,局部复发率7.7%,远处转移率7.3%,病死率3.2%。RFA组的局部复发率低于对照组（P〈0.05）,转移率、病死率的差异均无统计学意义（P〉0.05）。乳腺外观评价,RFA组的外观评分好于对照组（P〈0.05）。RFA组皮肤烧伤（4.4%）的并发症高于对照组（P〈0.01）。结论 ：术中射频治疗可以降低保乳术后的局部复发率,增加术后乳腺外观美感。

Objective：To evaluate the therapeutic effects of breast-conservative surgery combined with intra- operative radiofrequency ablation （RFA）in breast cancer.Methods：From June 2009 to June 2012,345 female patients with stage 0 to Ill a breast cancer were collected.All patients received breast-conservative surgery.A- mong them,98 patients accepted an intra-operative RFA after getting informed consent （RFA group）,the rest of 247 patients who did not accept RFA （control group）.Patients were foUow-up with a median period 33 months in control group（n=219）and 36 months in RFA group（n=90）.The complications,local recurrence,dis- tant metastases,mortality and cosmetic outcomes of two groups were compared.Results：Among 90 patients of RFA group,the local recurring rate was 2.2% ,the distant metastasis rate was 7.7% and the mortality was 3.3%.Among 219 patients in the control group,the local recurring rate was 7.7%,the distant metastasis rate was 7.3% and the mortality was 3.2%.The local recurring rate of the control group was higher than that of RFA group （P〈O.O5）.There was no difference between the two groups in the distant metastasis rate and mor- tality.The cosmetic score of RFA group was higher than that of the control group （P〈0.05）.The rate of skin burn in the group of RFA （4.4%）was higher than that of the control group （P〈0.01）.Conelusion：For patients with early stage breast cancer,intra-operative RFA after breast-conservative surgery could decrease the local recurring rate with a better cosmetic appearanee.