术后放疗对局部淋巴结阳性行保乳手术的乳腺癌患者临床预后的影响

Effect of Postoperative Radiotherapy on the Prognosis of Breast Cancer Patients with Lymph Node Metastasis Treated with Breast Conserving Surgery

目的研究术后放疗对局部淋巴结阳性行保乳手术的乳腺癌患者临床预后的影响。方法选择行保乳手术治疗并且出现局部淋巴结转移的84例乳腺癌患者,均于保乳手术后进行放疗。观察患者的5年和10年生存率、无瘤生存率、无远处转移生存率、无局部复发生存率;并分析影响预后的因素。结果患者的5年生存率为97.62%、无远处转移生存率为95.24%、无瘤生存率为94.05%、无局部复发生存率为95.24%;10年生存率为86.90%、无远处转移生存率为85.71%、无瘤生存率为82.14%、无局部复发生存率为85.71%。经过单因素分析发现,有无术后辅助化疗、有无术后放疗以及清扫淋巴结总数均为影响局部复发的危险因素;经过多因素COX回归分析发现,术后放疗是降低局部复发的惟一影响因素。结论术后放疗有利于改善局部淋巴结阳性行保乳手术的乳腺癌患者的临床预后情况,可以有效提高生存率,降低局部复发率,在保乳术后具有重要作用,值得应用推广。

Objective To study the effect of postoperative radiotherapy on prognosis of breast cancer patients with lymph node metastasis treated with breast conserving surgery.Methods 84 cases of breast cancer patients with lymph node metastasis treated with breast conserving surgery received radiotherapy after surgery.5-and 10-year survival rates,disease-free survival rates,distant metastasis-free survival rates,local recurrence-free survival rates were observed.The factors affecting the prognosis of patients were analyzed.Results 5-year survival rate was 97.62%,distant metastasis-free survival rate was 95.24%,disease-free survival rate was 94.05%,local recurrence-free survival rate was 95.24%.10-year survival rate was 86.90%,distant metastasisfree survival rate was 85.71%,disease-free survival rate was 82.14%,local recurrence-free survival rate was 85.71%.Single factor analysis showed that after surgery patients were given chemotherapy or not,radiotherapy or not,and the total number of lymph nodes were the risk factors of local recurrence.Multivariate analysis by COX regression showed that postoperative radiotherapy was the only risk factor to reduce local recurrence.Conclusion Postoperative radiotherapy can improve the clinical prognosis of breast cancer patients with lymph node metastasis treated with breast conserving surgery,effectively improve survival rate,and reduce the local recurrence rate.It plays an important role after conserving surgery,and it is worthy of promotion.