Felci U, Personeni A, Pompei L, Guzzetti R, Agazzi A, Quadri A
Divisione di Radioterapia e Oncologia, Ospedali Riuniti, Bergamo.
Radiol Med. 1990 Jan-Feb;79(1-2):87-91.
The authors examined 235 patients with early breast cancer treated by radiotherapy after conservative surgery during a 10-year period (1974-1984). Disease-free survival and incidence of local recurrences, in agreement with the data reported in literature, did not differ from those of patients with early breast cancer treated with radical surgery. As for local recurrences in the breast only (7/235), a slightly significant difference was observed in favor of quadrantectomy (3/62 for tumorectomy versus 4/173 for quadrantectomy). On the contrary, a significant difference was observed in the breast recurrence rate of premenopausal (5/7) and postmenopausal women (2/7). Complications occurred in 7.2% of the cases. Satisfactory esthetic results were generally obtained, with 78% good and excellent results. Doses greater than 50 Gy to the whole breast and irradiation of the axilla both worsened the esthetic results and increased complication rate. Chemotherapy does not worsen the esthetic results, while that is often the case when the removed volume is excessive in comparison to the whole breast volume.
作者对1974年至1984年这10年间接受保乳手术后放疗的235例早期乳腺癌患者进行了研究。无病生存率和局部复发率与文献报道的数据一致,与接受根治性手术的早期乳腺癌患者相比无差异。仅就乳腺局部复发而言(235例中有7例),观察到象限切除术略具显著优势(肿瘤切除术中62例中有3例,象限切除术中173例中有4例)。相反,绝经前(7例中有5例)和绝经后女性(7例中有2例)的乳腺复发率存在显著差异。7.2%的病例出现了并发症。总体上获得了令人满意的美学效果,78%为良好和优秀结果。全乳剂量大于50 Gy以及腋窝照射均会使美学效果变差并增加并发症发生率。化疗不会使美学效果变差,而当切除体积与全乳体积相比过大时情况往往如此。