Bataini J P, Picco C, Martin M, Calle R
Cancer. 1978 Oct;42(4):2059-65. doi: 10.1002/1097-0142(197810)42:4<2059::aid-cncr2820420457>3.0.co;2-q.
67 patients with tumors 3 cm or less and with negative axilla, who had lumpectomy and radiotherapy, and 122 patients with larger tumors or clinically positive axilla, who had radical radiotherapy without prior lumpectomy, were evaluated at five years to determine the optimum dose for local control. 7000 rad in seven to eight weeks controlled 85% of lumpectomy cases, whereas 8000 rad in 81/2 weeks were required to control two-thirds of cases treated by radical irradiation alone. Subclinical (N0, N1a) and clinical disease (N1b) in the axilla was controlled, in a very high percentage, when 6000 and 7000 rad were delivered, respectively. Dose response curves were obtained for clinical disease in the breast and axilla. No such response was elicited for subclinical disease. Undifferentiated cancers had higher recurrence rates than well differentiated tumors. Radiation fibrosis in lumpectomy cases was insignificant, whereas 10% of radically irradiated patients had fibrosis of the breast.
67例肿瘤大小为3厘米及以下且腋窝淋巴结阴性的患者接受了肿块切除术和放疗，122例肿瘤较大或临床腋窝淋巴结阳性的患者未先行肿块切除术而是接受了根治性放疗，对这些患者进行了为期五年的评估，以确定局部控制的最佳剂量。七至八周内给予7000拉德的剂量可控制85%的肿块切除病例，而仅接受根治性放疗的病例中，需要在8.5周内给予8000拉德的剂量才能控制三分之二的病例。当分别给予6000拉德和7000拉德的剂量时，腋窝的亚临床（N0、N1a）和临床疾病（N1b）得到了很高比例的控制。获得了乳腺和腋窝临床疾病的剂量反应曲线。亚临床疾病未出现此类反应。未分化癌的复发率高于高分化肿瘤。肿块切除病例中的放射性纤维化不明显，而接受根治性放疗的患者中有10%出现了乳腺纤维化。
