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Ⅱ期乳癌术后胸壁电子束弧形照射临床观察 被引量:2

Postmastectomy Electron-beam-rotation Irradiation in Stage ⅡBreast Cancer
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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。 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 79. 5 %, disease-free survival was 76. 4% (Kaplen-Meier analysis). Significant predictors of poor local tumor control was involved axillary lymph nodes)20%, the 5 year overall survival was 73.1% vs 84. 8% with involved axillary lymph nodes(20% (P〈0. 001). Conclusion ①In high-risk breast cancer patients of postmastectomy, irradiation with the electron beam rotation technique would obtaind optimal radiation dose distribution, it is an effective therapy resulting in a 5 year local(chest wall) failure rate of 6% and subsequently improve the survival rate and qulity of life. ②For the patient with involved axillary lymph nodes)20%, intensified local therapy and combined treatment measurment needs further investigation.
出处 《肿瘤防治研究》 CAS CSCD 北大核心 2006年第1期54-56,共3页 Cancer Research on Prevention and Treatment
关键词 乳腺癌 术后放疗 电子束弧形照射 Breast cancer Postmastectomy radiotherapy Electron beam rotation
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参考文献7

  • 1胡逸民.电子束旋转照射剂量学[M]..肿瘤放射物理学[C].北京:原子能出版社,1999.255-267.
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二级参考文献4

  • 1谷铣之,肿瘤放射治疗学,1993年
  • 2范乃斌,中国放射肿瘤学,1990年,4卷,3期,200页
  • 3余子豪,中国放射肿瘤学,1990年,4卷,3期,200页
  • 4徐博,申文江,李庆琪.Ⅱ期乳癌术后放疗的作用[J].中华放射肿瘤学杂志,1993,2(3):40-42. 被引量:10

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