Lim Yu Jin, Kim Kyubo, Chie Eui Kyu, Han Wonshik, Noh Dong Young, Ha Sung W
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. ; Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
Radiat Oncol J. 2014 Mar;32(1):1-6. doi: 10.3857/roj.2014.32.1.1. Epub 2014 Mar 27.
To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT).
We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy.
The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or ≥1 mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively).
Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.
评估接受手术及术后放疗（RT）的导管原位癌（DCIS）患者的治疗结果。
我们回顾性分析了1994年至2006年间106例接受手术及术后放疗的DCIS患者。94例患者接受了保乳手术，12例因广泛DCIS行乳房切除术。术后放疗全乳剂量为50.4 Gy/28次分割。7例患者（6.6%）接受了瘤床加量放疗。激素受体阳性肿瘤患者接受激素治疗。
中位随访时间为83.4个月（范围33.4至191.5个月），中位年龄为47.8岁。10例患者（9.4%）切缘<1 mm，39例（36.8%）和20例（18.9%）患者分别观察到高级别和雌激素受体阴性肿瘤。7年同侧乳腺肿瘤复发（IBTR）无病生存率为95.3%。在单因素和多因素分析中，切缘（<1或≥1 mm）是IBTR的显著预后因素（分别为p<0.001和p = 0.016）。
DCIS术后放疗可取得良好的治疗效果。切缘是接受术后放疗的DCIS患者IBTR的重要预后因素。
