Ⅱ期乳癌术后胸壁电子束弧形照射临床观察

Postmastectomy Electron-beam-rotation Irradiation in Stage ⅡBreast Cancer

摘要: 目的分析应用电子束弧形照射技术对Ⅱ期乳癌根治术后放疗的临床效果。方法对87例接受了乳癌改良根治术后的Ⅱ期患者实施了术后放疗。靶区为患侧锁骨上、下淋巴引流区、腋窝、胸壁(包括手术疤痕),肿瘤位于内侧象限者,加以内乳区照射。内乳区、胸壁采用电子束弧形照射。结果全组病例5年存活率为79.5%,5年无瘤存活率为76.4%,腋窝淋巴结阳性率<20%组5年生存率为84.8%;>20%组为73.1%(P<0.001)。结论①实施根据胸廓外型和靶区深度调整并转换电子束能量的弧形照射,可以得到理想的靶区剂量分布,改善放疗效果,提高乳癌病人的局部肿瘤控制率,从而改善存活率及生存质量。②腋窝淋巴结阳性率>20%提示预后较差,对此组病例应予以积极的综合治疗。

Abstract: Objective We review the results with the electron-beam-rotation technique in stage Ⅱ locally advanced breast cancer patients. Methods From 1993 to 2001,87 patients with stage Ⅱ locally advanced breast cancer underwent electron-beam-rotation irradiation of the chest wall and internal mammary lymph nodes with daily fractions of 200cGy per day to 40~50 Gy total dose after modified radical mastectomy and axillary lymph node dissection. Results After a median follow-up of 44 months, the 5-year overall survival was...