Fukutomi T, Yamamoto H, Nanasawa T, Tsukiyama I, Ogino H, Itabashi M, Hirota T
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 1992 Feb;93(2):183-8.
In order to clarify the role of radiotherapy in breast preserving surgery for early breast cancer, histological and biological effects of preoperative radiation were evaluated. Thirty-five T1N0 patients were treated by preoperative radiotherapy with beta-tron, cumulative doses of which were ranging from 25 Gy (5 Gy x 5) to 40 Gy (8 Gy x 5) and underwent subsequent modified radical mastectomy 2 or 3 weeks after the termination of radiotherapy. Clinical tumor shrinkage more than 50% was observed in 25 out of 35 cases (71%) but did not directly correlate with histological effects. Radiotherapy was basically ineffective within 25-30 Gy, whereas histological effects more than Grade 2 were gained in 8 out of 25 patients (32%), who had received 40 Gy or more. In the preoperative radiation group, there were more ER(+), PgR(+) and histologically well-differentiated cases than in the non-radiated stage I patients. Mitotic figures were also significantly reduced after radiotherapy, whereas the expression of c-erB-2 protein was unchanged between these two groups. Our data indicate the various radiosensitivity of breast cancer cells and the indication of hormone therapy for the conservative treatment of breast carcinoma.
为了阐明放射治疗在早期乳腺癌保乳手术中的作用，对术前放疗的组织学和生物学效应进行了评估。35例T1N0患者接受了使用β射线加速器的术前放疗，累积剂量为25 Gy（5 Gy×5）至40 Gy（8 Gy×5），并在放疗结束后2或3周接受了改良根治性乳房切除术。35例中有25例（71%）观察到临床肿瘤缩小超过50%，但与组织学效应无直接关联。放疗在25 - 30 Gy范围内基本无效，而在接受40 Gy或更高剂量的25例患者中有8例（32%）获得了2级以上的组织学效应。术前放疗组中ER(+)、PgR(+)和组织学高分化病例比未接受放疗的Ⅰ期患者更多。放疗后有丝分裂象也显著减少，而两组之间c-erB-2蛋白的表达没有变化。我们的数据表明乳腺癌细胞具有不同的放射敏感性以及激素治疗在乳腺癌保守治疗中的指征。
