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目的 探讨早期乳腺癌患者根治术后放射治疗的作用。方法 回顾分析 6 0 5例T1～2N0～ 1M0乳腺癌患者接受乳腺癌根治性手术后的治疗情况 ,149例患者单纯手术 ,135例术后放疗 ,113例术后化疗或三苯氧胺治疗 ,2 0 8例术后化疗或三苯氧胺治疗加放疗。生存分析采用Kaplan Meier方法和Logrank检验。结果 单纯手术组与手术 +放射治疗组的 10年局部区域复发率分别为 18.7%和 7.5 % (P =0 .0 17) ,总生存率分别为 82 .1%和 81.1% (P =0 .6 18) ,无瘤生存率分别为 6 5 .2 %和71.6 % (P =0 .45 7)。术后放射治疗能显著降低局部区域复发率 ,但对总生存率和无瘤生存率无明显影响。单纯术后全身治疗组和术后全身治疗 +放射治疗组的 10年局部区域复发率分别为 2 1.1%和9.5 % (P =0 .0 0 1) ,总生存率为 75 .5 %和 85 .0 % (P =0 .0 2 0 ) ,无瘤生存率为 5 9.3%和 70 .2 % (P =0 .0 0 3)。术后放射治疗 +化疗不仅可显著降低局部区域复发率 ,还可提高无瘤生存率和总生存率。对腋窝淋巴结数≥ 4个接受全身治疗的患者 ,放射治疗有明显的疗效 ,能显著降低局部区域复发率 ,提高无瘤生存率和总生存率 ,这组患者未放射治疗组和放射治疗组的 10年局部区域复发率分别为40 .1%和 15 .1% (P =0 .0 0 1) ,总生存率为 5 4.4%和 6 7.
Objective To investigate the effect of radical radiotherapy in patients with early stage breast cancer. Methods A retrospective analysis of 650 cases of T1 ~ 2N0 ~ 1M0 breast cancer patients undergoing radical surgery after radical surgery, 149 patients with simple surgery, 135 cases of postoperative radiotherapy, 113 cases of postoperative chemotherapy or tamoxifen treatment, 208 Cases of postoperative chemotherapy or tamoxifen plus radiotherapy. Survival analysis using Kaplan Meier method and Logrank test. Results The 10-year regional recurrence rates in the surgery alone group and the radiotherapy group were 18.7% and 7.5%, respectively (P = 0.017). The overall survival rates were 82.1% and 81.1%, respectively. 6 18). The tumor-free survival rates were 65.2% and 71.6%, respectively (P = 0.457). Postoperative radiotherapy can significantly reduce the recurrence rate in the local area, but has no significant effect on the overall survival and tumor-free survival rate. The 10-year local recurrence rates in the postoperative systemic and postoperative systemic and radiotherapy groups were 21.1% and 9.5%, respectively (P = 0.001), and the overall survival rates were 75.5% and 85% respectively .0% (P = 0.020), and the tumor-free survival rates were 59.3% and 70.2% (P = 0.0030). Postoperative radiotherapy + chemotherapy can not only significantly reduce the recurrence rate in local area, but also improve the tumor-free survival rate and overall survival rate. Radiation therapy has obvious curative effect on patients who have more than 4 axillary lymph nodes and receive systemic therapy. It can significantly reduce the recurrence rate in local area and improve the tumor-free survival rate and overall survival rate. In this group, the radiotherapy group and radiotherapy group The local recurrence rates in 10 years were 40.1% and 15.1% (P = 0.001), respectively, with a overall survival of 54.4% and 67%.