乳腺癌术后放疗对局部复发的影响

Effect of Postoperative Radiotherapy on Local Recurrent of Breast Cancer

目的 :评价乳腺癌术后放疗的作用。方法 :选择 117例根治术后乳腺癌患者 ,用 χ2 检验比较 3年局部复发率。结果 :全组 3年局部复发率 12 8% ,无内乳、腋窝复发患者。胸壁复发占局部复发的80 % (12 15 )。无腋窝淋巴结转移 ,但乳腺肿块位于内象限、中央区或腋窝淋巴结转移 1～ 3个的 80例中 ,3年局部复发率为 8 75 % ,对于接受或未接受术后放疗患者分别为 10 3%、7 3% ,差异无显著性 (P>0 0 5 )。对于乳腺肿块 <5cm或≥ 5cm患者分别为 3 17%、2 9 4 1% ,差异有显著性 (P =0 0 0 4 )。结论 :无腋窝淋巴结转移但乳腺肿块位于内象限、中央区或腋窝淋巴结转移 1～ 3个可不作为术后常规术后放疗指征 ,但此种情况下若乳腺肿块≥ 5cm ,或腋窝淋巴结转移≥ 4个 ,尤其当腋窝淋巴结转移 >10个时 ,应该进行包括胸壁照射在内的术后放疗。

Objective To evaluate the role of postoperative radiotherapy for breast cancer patients.Methods The 3 year local recurrent rate of 117 cases of breast cancer after surgery were analyzed with χ 2 test.Results The local recurrent rate was 12 8% (15/117),and there were no internal mammary lymph node or axillary lymph node recurrent,while the chest wall recurrent dominated 80% of them(12/15).In 80 cases which had no axillary lymph nodes metastasis but breast mass located at internal quadrant or central area or axillary lymph nodes metastasis with 1-3,and their 3 year local recurrent rate was 8 75%.The 3 year local recurrent rates were 10 3% and 7 3 % respectively for those cases with or without postoperative radiotherapy( P >0 05),and there were no statistic significance;while they were 3 17% and 29 41% respectively for those cases with the primary masses smaller and bigger than 5 cm( P =0 004),difference was significant.Conclusions For those cases of which have no axillary lymph nodes metastasis but primary masses which located at internal quadrant or central area or only 1-3 axillary lymph nodes metastasis,there are no indications for postoperative radiotherapy,but for those primary masses bigger than 5 cm or axillary lymph nodes metastases more than 4,especially more than 10,it is necessary to accept postoperative radiotherapy. China J Cancer Prev Treat,2003,10(3):303-305