论文部分内容阅读
目的：探讨早期乳腺癌最佳治疗方式。方法：自1990年4月至1995年4月，本院共48例早期乳腺癌患者接受了保守外科加术后放疗。其中0期1例，Ⅰ期33例，Ⅱ期14例。45例行乳房1／4切除加腋窝淋巴结清扫，3例患者只作肿瘤切除未行腋淋巴结清扫。全部患者均接受围手术期化疗4～7周（CMF或CAF方案）。放疗采用4～6MV X线，全乳切线照射，中平面剂量45Gy，瘤床用电子束补加15Gy，9例腋淋巴结阳性者中5例接受区域淋巴结放疗，剂量50Gy。结果：1例失访，余患者随访满5～9年，寿命表法计算5年生存率98．9％47．5／48，局部复发率为6．25％3／48， 远处转移率为4．17％2／48，乳房保留率为93．8％45／48。5年生存率优于本院同期乳腺癌根治术的结果，与国内外报道相似。结论：保守外科加放射治疗是早期乳腺癌患者的首选治疗。
Objective: To explore the best treatment for early breast cancer. Methods: From April 1990 to April 1995, a total of 48 patients with early-stage breast cancer were treated with conservative surgery plus postoperative radiotherapy. There were 1 case in phase 0, 33 in phase I and 14 in phase II. 45 patients underwent 1/4 excision of the breast and axillary lymph node dissection. Three patients underwent tumor resection without axillary lymph node dissection. All patients received perioperative chemotherapy for 4 to 7 weeks (CMF or CAF protocol). Radiotherapy used 4-6MV X-rays, whole milk tangential irradiation, mid-planar dose of 45Gy, tumor bed with electron beam plus 15Gy, 9 cases of axillary lymph node positive in 5 cases received regional lymph node radiotherapy, dose 50Gy. Results: One case was lost to follow-up. The remaining patients were followed up for 5-9 years. The 5-year survival rate was 98.9%47.5/48. The local recurrence rate was 6.25%3/48. The distant metastasis rate was 4.17%2/48 and the breast retention rate was 93.8%45/48. The 5-year survival rate was better than the results of radical mastectomy in this hospital at the same time, which was similar to domestic and foreign reports. Conclusion: Conservative surgery plus radiation therapy is the first choice for early breast cancer patients.