Spruit Patty H, Siesling Sabine, Elferink Marloes A G, Vonk Ernest J A, Hoekstra Carel J M
Radiotherapeutic Institute RISO, Deventer, The Netherlands.
Radiat Oncol. 2007 Oct 30;2:40. doi: 10.1186/1748-717X-2-40.
BACKGROUND: The standard treatment of the axilla in breast cancer used to be an axillary lymph node dissection. An axillary lymph node dissection is known to give substantial risks of morbidity. In recent years the sentinel node biopsy has become common practice. Future randomized study results will determine whether the expected decrease in morbidity can be proven. METHODS: Before the introduction of the sentinel node biopsy, we conducted a study in which 180 women of 50 years and older with T1/T2 cN0 breast cancer were treated with breast conserving therapy. Instead of an axillary lymph node dissection regional radiotherapy was given in combination with tamoxifen (RT-group). The study group was compared with 341 patients, with the same patient and tumour characteristics, treated with an axillary lymph node dissection (S-group). RESULTS: The treatment groups were comparable, except for age. The RT-group was significantly older than the S-group. The median follow up was 7.2 years. The regional relapse rates were low and equal in both treatment groups, 1.1% in RT-group versus 1.5% in S-group at 5 years. The overall survival was similar; the disease free survival was significant better in the RT-group. CONCLUSION: Regional recurrence rates after regional radiotherapy are very low and equal to an axillary lymphnode dissection.
背景：乳腺癌腋窝的标准治疗方法过去一直是腋窝淋巴结清扫术。众所周知，腋窝淋巴结清扫术会带来较高的发病风险。近年来，前哨淋巴结活检已成为常用方法。未来的随机研究结果将确定预期的发病率降低是否能够得到证实。 方法：在引入前哨淋巴结活检之前，我们进行了一项研究，对180名年龄在50岁及以上的T1/T2 cN0期乳腺癌女性患者采用保乳治疗。该组未进行腋窝淋巴结清扫，而是采用区域放疗联合他莫昔芬治疗（放疗组）。将该研究组与341名具有相同患者和肿瘤特征、接受腋窝淋巴结清扫术的患者（手术组）进行比较。 结果：除年龄外，治疗组具有可比性。放疗组的年龄显著高于手术组。中位随访时间为7.2年。两个治疗组的区域复发率均较低且相等，5年时放疗组为1.1%，手术组为1.5%。总体生存率相似；放疗组的无病生存率显著更好。 结论：区域放疗后的区域复发率非常低，与腋窝淋巴结清扫术相当。
Curr Treat Options Oncol. 2011-12
Am J Surg. 2004-1
Eur J Surg Oncol. 2003-5
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