乳腺癌瘤床插植(保乳)放射治疗59例

RADIOTHERAPY AND BRACHYTHERAPY OF THE TUMOR BED AFTER BREAST CONSERVING SURGERY FOR 36 BREAST CANCER PATIENTS

目的 探讨乳腺癌保乳手术加根治性放疗和瘤床间质放疗的治疗原则及近期疗效。 方法 59例各期乳腺癌患者施保乳手术(单纯肿瘤切除+腋淋巴结清扫术)、术中或术后瘤床插植HDR192Ir针管放疗±化疗。靶区一次性放疗8Gy。手术后2～4周再接受全乳腺外照射,乳腺用切线野在5周被照射50Gy。随访时间平均为37个月。 结果 59例患者全部存活,无一例出现局部复发。无明显放射反应。双乳对称,外形美观。 结论 早期乳腺癌患者接受保乳手术加根治性放疗可以取得满意的临床效果。

PURPOSE To evaluate the treatment principle and the preliminary outcome of breast cancer treated with breast conserving surgery plus radical breast irradiation and brachytherapy.METHODS Fifty nine breast cancer patients were treated with tumorectomy or quadrantectomy and axillary nodes dissection followed by intraoperative or post operative brachytherapy of the tumor bed and total breast irradiation with or without chemotherapy.An interstitial 192 Ir implant of HDR was performed with 8?Gy delivered to the volume of interest.The breast was treated with tangential fields using 10?MV photons to deliver 50?Gy in 2?Gy daily dose,in five weekly fractions.Minimum follow up is 5 months (median,37 months;maximum,50?months).RESULTS All patients are allive without local recurrence.Metastasis to bone was found in one patient.There were no late side effect in the breast and lung.Good cosmesiswas noted in all of the patients except one. CONCLUSIONS Breast conservingsurgery and radical radiation therapy including brachytherapy is an effective treatment for patients in early stages of carcinoma of the breast.