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[目的]回顾分析早期乳腺癌保留乳房手术治疗的临床效果,评价保乳术后改良放疗对远期疗效的影响。[方法]2004年1月~2006年1月就诊的90例早期乳腺癌患者,单盲随机将接受改良放疗保乳术治疗的49例患者分为改良组,其余41例分为对照组。χ2检验对照分析术后患者对乳房美容效果评价结果、术后复发及转移结果和放疗不良反应结果。[结果]两组患者对乳房美容效果评价结果对照分析显示差异无统计学意义(P﹥0.05)。改良组放射性皮炎高于对照组,差异有统计学意义(P﹤0.01)。两组患者局部复发率及淋巴结复发率对照分析显示差异无统计学意义(P﹥0.05),而远处转移率差异有统计学意义(P﹤0.01)。而血小板下降及白细胞下降等毒性反应差异无统计学意义(P﹥0.05)。[结论]保乳术后改良放疗可有效降低远处转移率,提高患者生活质量,可在临床中推广,以进一步提高患者术后的生存率。
[Objective] To retrospectively analyze the clinical effect of breast conserving breast surgery in early breast cancer and evaluate the effect of modified radiotherapy after breast-conserving surgery on long-term effect. [Method] From January 2004 to January 2006, 90 patients with early stage breast cancer were randomly divided into modified group and control group. The other 49 patients were treated with modified radiotherapy and conservative operation. χ2 test control analysis of postoperative breast cosmetic evaluation results, postoperative recurrence and metastasis results and radiotherapy adverse reactions results. [Results] The two groups of patients on breast cosmetic evaluation results showed that the difference was not statistically significant (P> 0.05). Radiation dermatitis in the improved group was higher than that in the control group, with significant difference (P <0.01). The two groups of patients with local recurrence rate and lymph node recurrence rate analysis showed no significant difference (P> 0.05), while distant metastasis rate difference was statistically significant (P <0.01). The thrombocytopenia and leukopenia and other toxicity differences were not statistically significant (P> 0.05). [Conclusion] The modified radiotherapy after breast-conserving surgery can effectively reduce the distant metastasis rate and improve the quality of life of the patients and can be popularized in the clinic so as to further improve the postoperative survival rate of the patients.