Yogi Veenita, Singh O P, Malviya Anupam, Ghori H U
Department of Radiation Oncology, Gandhi Medical College, Bhopal, Madhya Pradesh, India.
J Cancer Res Ther. 2018 Jul-Sep;14(5):1054-1058. doi: 10.4103/jcrt.JCRT_172_16.
Cystosarcoma phyllodes of the breast, an uncommon sarcoma found primarily in women of the age group of 35-55 years, constitutes <1% of all breast neoplasms. These tumors are resistant to chemotherapy and hormonal therapies and often recur aggressively after initial surgery. Limited research is available about the role and effectiveness of adjuvant radiotherapy in reducing recurrences.
Surgery has been the primary treatment modality to date but with high recurrence rates. The purpose of this retrospective study is to highlight the role of postoperative time for adjuvant radiotherapy in aggressive borderline and malignant phyllodes tumor (PT).
This retrospective study reviewed 13 histopathologically proven borderline and malignant PT, treated with radiation therapy to the dose of 50 Gray by external beam radiotherapy (EBRT) after primary surgical management.
The mean age at presentation was 33 years. Right laterality was more common (60% cases). Although all patients presented with lump, those who had pain as an added symptom turned out to be histopathologically malignant later on. Histopathologically, 66.6% patients were malignant, 20% borderline, and 13.3% benign. High mitotic index and stromal activity were observed in younger patients. Patients who received EBRT within a month of surgery had no local recurrence, whereas those who received EBRT after a month developed local recurrence (P = 0.012).
Adjuvant radiotherapy is appropriate treatment for aggressive borderline and malignant PT. This study revealed that time interval between surgery to initiation of EBRT plays a significant role in the prevention of recurrence.
乳腺叶状囊肉瘤是一种罕见的肉瘤，主要见于35 - 55岁年龄组的女性，占所有乳腺肿瘤的比例不到1%。这些肿瘤对化疗和激素治疗耐药，在初次手术后常易复发。关于辅助放疗在降低复发率方面的作用和有效性的研究有限。
迄今为止，手术一直是主要的治疗方式，但复发率很高。这项回顾性研究的目的是强调辅助放疗的术后时间在侵袭性交界性和恶性叶状肿瘤（PT）中的作用。
这项回顾性研究回顾了13例经组织病理学证实的交界性和恶性PT，在初次手术治疗后接受了外照射放疗（EBRT），剂量为50格雷。
就诊时的平均年龄为33岁。右侧发病更为常见（60%的病例）。尽管所有患者均表现为肿块，但那些伴有疼痛症状的患者后来在组织病理学上被证实为恶性。组织病理学上，66.6%的患者为恶性，20%为交界性，13.3%为良性。在年轻患者中观察到高有丝分裂指数和间质活性。在术后一个月内接受EBRT的患者无局部复发，而在术后一个月后接受EBRT的患者出现了局部复发（P = 0.012）。
辅助放疗是侵袭性交界性和恶性PT的合适治疗方法。这项研究表明，手术至开始EBRT的时间间隔在预防复发方面起着重要作用。
