Jiveliouk Irina, Corn Benjamin, Inbar Moshe, Merimsky Ofer
Department of Oncology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Oncology. 2009;76(1):30-5. doi: 10.1159/000178162. Epub 2008 Nov 26.
Lumpectomy followed by radiation therapy (RT) has become an accepted local management strategy for patients with small, mammographically detected ductal carcinoma in situ (DCIS) of the breast. The aim of this analysis is to describe control rates and patterns of relapse in a cohort of Israeli women with mammographically detected DCIS treated at a single medical center.
The files of 107 consecutive patients with DCIS were retrieved from the cancer registry of the unit of RT. All women underwent lumpectomy followed by definitive RT, administered in conventional dose fractionation regimens. Oral tamoxifen, 20 mg/ day, was prescribed to all but 2 patients with positive receptors.
Within a median follow-up time of 52 months, no local recurrence of any breast tumor was found. There was no correlation between event-free survival and tumor size, focality, grading, hormone receptor status, administration of adjuvant hormonal therapy, timing of RT, and RT boost delivery. The 8-year overall survival, disease-free-survival, and event-free survival were 100, 100, and 87%, respectively.
The results reported herein are consistent with short-term and intermediate-term outcomes that are better than the reported benchmarks from prospective randomized trials. Although this could reflect selection factors at a single institution, it is also plausible that a genetically distinct disease is present in this local population.
对于乳腺钼靶检查发现的小的导管原位癌（DCIS）患者，保乳手术联合放射治疗（RT）已成为一种被认可的局部治疗策略。本分析的目的是描述在一家单一医疗中心接受乳腺钼靶检查发现的DCIS治疗的以色列女性队列中的控制率和复发模式。
从放疗科癌症登记处检索了107例连续的DCIS患者的病历。所有女性均接受了保乳手术，随后进行了确定性RT，采用常规剂量分割方案给药。除2例受体阳性患者外，所有患者均给予20mg/天的口服他莫昔芬。
在中位随访时间52个月内，未发现任何乳腺肿瘤的局部复发。无事件生存期与肿瘤大小、灶性、分级、激素受体状态、辅助激素治疗的使用、RT时间和RT增敏给药之间无相关性。8年总生存率、无病生存率和无事件生存率分别为100%、100%和87%。
本文报道的结果与短期和中期结果一致，优于前瞻性随机试验报道的基准。虽然这可能反映了单一机构的选择因素，但也有可能在这个当地人群中存在一种基因上不同的疾病。
