伴高危因素且未发生淋巴结转移的T_(1-2)期乳腺癌术后患者放疗疗效及预后分析

Radiotherapy efficacy and prognosis of patients with stage T_(1-2) breast cancer with high risk factors without lymph node metastasis

目的:探讨术后放疗对T_(1-2)期N0伴有脉管癌栓、神经侵犯、病灶多灶性、侵及周围脂肪组织等高危因素的乳腺癌患者的疗效及预后的影响。方法:选取2009年01月至2014年01月在我院行乳腺癌改良根治术后放疗的患者共100例,随机分为观察组和对照组,观察组给予胸壁及锁骨上下野放疗,对照组不行放疗,比较两组患者局部复发率、远处转移率、2年生存率、3年生存率。结果:随访3年,观察组的2年局部复发率与对照组比较差异无统计学意义(P>0.05);观察组2年远处转移率低于对照组,差异有统计学意义(P<0.05);观察组的3年局部复发率、远处转移率均明显低于对照组,差异具有统计学意义(P<0.05);观察组的2年、3年生存率高于对照组,但差异无统计学意义(P>0.05)。结论:对于低危乳腺癌患者中具有高危因素给予选择性行胸壁及锁骨上下野放疗,可降低局部复发率及远处转移率。

Objective ：To investigate the effect of postoperative radiotherapy on breast cancer patients with T1- 2N0 associated with vascular thrombosis, nerve invasion, multifocal lesions,invasion of surrounding adipose tissue. Meth- ods：A total of 100 patients were randomly divided into the observation group and the control group. The observation group was given chest and supraclavicular radiotherapy, and the control group was not treated with radiotherapy. The two groups of patients with local recurrence rate, distant metastasis rate,2 - year and 3 - year survival rates were compared. Results ： There was no significant difference in the 2 - year recurrence rate between the two groups （ P 〉 0.05 ）. 2 - year distant metastasis rate of observation group was lower than control. The difference was statistically significant （ P 〈 0.05 ）. The 3 - year recurrence rate and distant metastasis rate of the observation group were signifi- cantly lower than those of the control group （ P 〈 0.05 ）. The 2 - year and 3 - year survival rates of the observation group were higher than those of the control group （ P 〉 0.05 ）. Conclusion ： For low - risk breast cancer patients with high risk factors, to give selective thoracic wall tangential field and supraclavicular radiotherapy, can reduce the chance of local recurrence and distant metastasis probability.