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目的 观察Ⅰ期乳腺癌保乳术后三维适形放疗疗效及副作用.方法 30例确诊Ⅰ期乳腺癌患者保乳术后进行三维适形放疗.照射靶区为患侧全乳及胸壁和腋窝锁骨上区.全乳及胸壁采用半野切线对穿照射,90%PTV DT50 Gy/25次/5周,靶区内剂量分布±5.0%,患侧肺V20＜20%.瘤床野以术痕外扩3.0 cm,避开乳头,银夹的位置为瘤床深度,5 mm等效膜填充,6MeV电子线追加照射,DT10Gy/5次/1周.患侧腋窝锁骨上区6MV-X照射DT50 Gy/25次/5周.结果 随访5年未见局部复发.美容效果“优”和“好”100%.近期毒副反应可耐受.结论 早期乳腺癌保乳术加术后三维适形放疗局部控制率及美容效果满意,无严重并发症.“,”Objective To observe the curative effects and side reactions of patients suffer from stage Ⅰ breast cancer after breast-conserving combining with three-dimensional conformal radiotherapy (3D CRT).Methods Thirty clinical stage Ⅰ breast cancer patients received 3D CRT after breast-conserving therapy.A dose of 50 Gy with 6-MV X-rays was prescribed to the target volume consisting of the involved breast,chest wall,supraclavicular,and axillary nodes.And added 10 Gy to the tumor bed with 6-MeV electrons.Results The follow-up time was five years.No patients recurred.All patients obtained excellent cosmetic result.And the short term side reactions is acceptable.Conclusion Three-dimensional conformal radiotherapy combined with breastconserving therapy can well achieve ideal local control rate and cosmetic outcome for earlier breast cancer.And no serious complication is observed.