早期乳腺癌患者在改良根治术后ER(-)和PR(-)行辅助放疗治疗的临床意义

The clinical significance of the treatment of early breast cancer in the adjuvant radiotherapy after modified radical mastectomy ER(-) and PR(-)

目的探讨术后辅助放疗在改良根治术后ER（-）和PR（-）的早期乳腺癌患者中,降低其局部区域复发率（LRR）、远处转移率（DM）、无瘤生存率（DFS）和总生存率（OS）的临床价值。方法选取2011年1月~2013年1月本院有完整病历资料的行乳腺癌改良根治术患者80例,根据病情及患者意愿分为术后辅助化疗组、术后辅助放化疗组。术后辅助放疗组直线加速器行患侧锁骨上窝及胸壁放疗,术后每3个月随访一次。观察患者的乳腺心脏彩超、胸部正位片、肿瘤指标等,以观察患者3年LRR、DM、DFS和OS的差别,来显示术后辅助放疗的临床意义。观察放疗过程中出现的骨髓抑制、放射性肺炎、放射性的心脏损害等副反应。结果两组3年LRR分别为25%（10/40）、10%（4/40）;DM分别为45%（18/40）、30%（12/40）;DFS分别为12/40（30%）、24/40（60%）;OS率分别为24/40（60%）、32/40（80%）。结论术后辅助放疗对ER（-）和PR（-）的改良根治术后早期乳腺癌患者,可降低其LRR、DM,改善DFS和OS,具有重要的临床意义。

Objective To explore postoperative auxiliary radiotherapy for ER（-） and PR（-） improved radical postoperative patients with early breast cancer reduced the local recurrence rate（LRR）,distant metastasis rate（DM）,disease-free survival（DFS） and overall survival rate（OS） of clinical value.Methods From January 2011 to January 2013 collected in our hospital 80 cases of patients with complete medical records.Breast cancer modified radical mastectomy,based on condition and the willingness of patients divided into postoperative adjuvant chemotherapy group,postoperative auxiliary chemotherapy group.Postoperative radiotherapy for patients with postoperative adjuvant radiotherapy was performed on the side of the side of the chest wall,and the patients were followed up once every three months.Observation of the patient’s breast echocardiogram,chest radiographs,tumor index to observe the patients three years LRR,DM,DFS and OS,difference to display the postoperative adjuvant radiotherapy to the clinical significance and the observation of radiotherapy of bone marrow suppression,radiation pneumonitis,radiation injury of heart and other side effects.Results Postoperative adjuvant chemotherapy group,postoperative adjuvant radiotherapy and chemotherapy group,three years of LRR rate were 25%（10/40）,10%（4/40）,DM rate were 45%（18/40）,30%（12/40）,DFS were 30%（12/40）,60%（24/40）,OS rate respectively（24/40）60% and（32/40）80%.Conclusion Postoperative adjuvant radiotherapy for ER（-） and PR（-） of modified radical mastectomy for early breast cancer patients to reduce the LRR,DM rate,and improve DFS and OS rate has important clinical significance.