Hackl A
Wien Med Wochenschr. 1985 Dec 31;135(23-24):587-90.
The role of radiotherapy in breast cancer has been to supply and complete radical or simple mastectomy, conservative surgery, and to improve quality of life in cases of disseminated disease. The concept of conservative surgery and radiation is based on successful treatment while preserving the breast. In randomized trials there were no significant differences in disease-free, distant-disease free or overall survival of patients treated by radical mastectomy or segmental mastectomy followed by breast irradiation. Adjuvant radiotherapy in treatment of operable breast cancer remains controversial, although most oncologists agree that it provides local and regional control of tumor. Preirradiation multidrug chemotherapy was added in inflammatory carcinoma of the breast, in patients with high risk of dissemination, and in gross local recurrences. Radiotherapy does relieve pain and disability caused by bone metastases in 80% and effective palliation is achieved by treatment of brain metastases.
放射疗法在乳腺癌治疗中的作用一直是辅助并完善根治性或单纯乳房切除术、保守性手术，以及改善播散性疾病患者的生活质量。保守性手术加放疗的理念基于在保留乳房的同时成功治疗疾病。在随机试验中，接受根治性乳房切除术或乳房部分切除术后进行乳房照射的患者，其无病生存期、无远处疾病生存期或总生存期并无显著差异。尽管大多数肿瘤学家都认为辅助放疗可实现肿瘤的局部和区域控制，但在可手术乳腺癌的治疗中，辅助放疗仍存在争议。对于炎性乳腺癌、有高播散风险的患者以及局部明显复发的患者，在放疗前加用了多药化疗。放射疗法确实能缓解80%由骨转移引起的疼痛和功能障碍，对脑转移的治疗也能有效减轻症状。
