Bruckman J E, Harris J R, Levene M B, Chaffey J T, Hellman S
Cancer. 1979 Mar;43(3):985-93. doi: 10.1002/1097-0142(197903)43:3<985::aid-cncr2820430330>3.0.co;2-1.
One hundred sixteen patients with stage III carcinoma of the breast were treated by primary radiation therapy. The 5-year actuarial survival and relapse-free survival were 25% and 22%, respectively. The 5-year actuarial probability of local tumor control for the entire group was 64%. In patients undergoing an excisional biopsy and an interstitial implant of the primary tumor area, local control was 100%. In patients who had either an excisional biopsy or an implant, the 5-year actuarial probability of local control was 77% and 76%, respectively. In contrast, in patients having neither an excisional biopsy nor an implant, local control was only 41%. In patients receiving a total dose of greater than 6000 rad, from external beam treatment or from external beam plus an interstitial implant, the local control was 78% compared to 39% in patients receiving a total dose of less than 6000 rad. Forty-one patients received some form of adjuvant therapy. Both local control and relapse-free survival were improved in patients receiving chemotherapy as the sole adjuvant and in patients receiving chemotherapy combined with an endocrine ablative procedure. However, patients treated with only an endocrine ablative procedure had no improvement in survival nor in local control. These results indicate that primary radiation therapy can provide local control in a high proportion of patients with stage III carcinoma of the breast and suggest that chemotherapy is effective in improving both local control and survival in these patients.
116例Ⅲ期乳腺癌患者接受了原发灶放射治疗。5年精算生存率和无复发生存率分别为25%和22%。整个组的5年精算局部肿瘤控制概率为64%。在接受原发肿瘤区域切除活检和组织间植入的患者中，局部控制率为100%。在仅接受切除活检或仅接受植入的患者中，5年精算局部控制概率分别为77%和76%。相比之下，既未接受切除活检也未接受植入的患者，局部控制率仅为41%。在接受外照射治疗或外照射加组织间植入且总剂量大于6000拉德的患者中，局部控制率为78%，而总剂量小于6000拉德的患者局部控制率为39%。41例患者接受了某种形式的辅助治疗。接受单纯化疗作为辅助治疗的患者以及接受化疗联合内分泌消融治疗的患者，局部控制和无复发生存均得到改善。然而，仅接受内分泌消融治疗的患者在生存率和局部控制方面均无改善。这些结果表明，原发灶放射治疗能在很大比例的Ⅲ期乳腺癌患者中实现局部控制，并提示化疗在改善这些患者的局部控制和生存率方面是有效的。
