Calle R, Pilleron J P, Schlienger P, Vilcoq J R
Cancer. 1978 Oct;42(4):2045-53. doi: 10.1002/1097-0142(197810)42:4<2045::aid-cncr2820420455>3.0.co;2-8.
514 patients were treated for a surgically operable (T1, T2, T3, N0, N1a, N1b) infiltrating breast carcinoma at the Foundation Curie, Paris, France, from 1960 to 1970 inclusive. Patients with tumors 3 cm or less and without axillary adenopathy had lumpectomy followed by radiotherapy. Patients with larger tumors and all patients with clinically significant lymph nodes (N1b) had exclusive radiotherapy (without lumpectomy). 120 had lumpectomy and 394 had exclusive radiotherapy. The five and ten years absolute survivals, free of disease (N.E.D.), for the lumpectomy are 85% and 75%, respectively. 12% had secondary surgery for local recurrence. The cosmetic results were satisfactory in 98%, with no severe radiation sequelae. The five and ten years, N.E.D., of the exclusive radiotherapy group are 68% and 43%. 55% had secondary surgery for persistent or recurrent disease. The cosmetic results were satisfactory in 85%. There were only three patients with severe radiation sequelae. The overall survival for 514 patients at five and ten years are 72% and 51%. Two-thirds of patients, alive at five years, had a preserved breast. Our conservative treatment resulted in survival at five and ten years comparable to those of radical surgery.
1960年至1970年(含)期间,法国巴黎居里基金会对514例患有可手术切除(T1、T2、T3、N0、N1a、N1b)浸润性乳腺癌的患者进行了治疗。肿瘤直径3厘米及以下且无腋窝淋巴结病的患者接受了肿块切除术,随后进行放射治疗。肿瘤较大的患者以及所有具有临床意义的淋巴结(N1b)患者接受单纯放射治疗(未进行肿块切除术)。120例患者接受了肿块切除术,394例患者接受了单纯放射治疗。接受肿块切除术的患者五年和十年无病生存率分别为85%和75%。12%的患者因局部复发接受了二次手术。98%的患者美容效果令人满意,且无严重放疗后遗症。单纯放射治疗组的五年和十年无病生存率分别为68%和43%。55%的患者因疾病持续或复发接受了二次手术。85%的患者美容效果令人满意。只有三名患者出现严重放疗后遗症。514例患者的五年和十年总生存率分别为72%和51%。五年存活的患者中有三分之二保留了乳房。我们的保守治疗在五年和十年时的生存率与根治性手术相当。