Solin L J, Fowble B, Martz K L, Goodman R L
Department of Radiation Therapy, University of Pennsylvania School of Medicine, Philadelphia.
Int J Radiat Oncol Biol Phys. 1988 Feb;14(2):235-42. doi: 10.1016/0360-3016(88)90426-9.
From 1977 to 1984, 552 breast cancers in 548 women were treated with definitive irradiation following breast-conserving surgery at the Hospital of the University of Pennsylvania and the Fox Chase Cancer Center. All patients had invasive carcinoma and were AJC clinical Stage I or II. Pathologic axillary lymph node staging was known for all cases. The 5-year actuarial survival for the entire group was 93% with an NED survival of 81%. The 5-year survival for clinical Stage I and II patients was 97 and 87%, respectively, with a corresponding NED survival of 87 and 73%, respectively. For pathologic Stage I and II patients, the corresponding survival figures were 97 and 89%, respectively, with NED survival rates of 86 and 76%, respectively. The overall 5-year actuarial local failure rate was 6%, and the rate of local only as the first failure was 3%. The overall local-regional failure rate was 13% with a local-regional only first failure rate of 8%. These results compare favorably with other reported series and contribute a substantial number of patients to the increasing experience with definitive irradiation following breast-conserving procedures. The relatively low incidence of breast recurrence may be related to the emphasis on integrating the surgical, pathologic, and radiotherapeutic aspects of treatments, as well as the emergence of a re-excision policy for patients at high risk to have residual tumor.
1977年至1984年期间，宾夕法尼亚大学医院和福克斯蔡斯癌症中心对548名女性的552例乳腺癌患者进行了保乳手术后的根治性放疗。所有患者均为浸润性癌，AJC临床分期为I期或II期。所有病例均已知病理腋窝淋巴结分期。整个组的5年精算生存率为93%，无病生存率为81%。临床I期和II期患者的5年生存率分别为97%和87%，相应的无病生存率分别为87%和73%。对于病理I期和II期患者，相应的生存率分别为97%和89%，无病生存率分别为86%和76%。总的5年精算局部失败率为6%，仅局部作为首次失败的发生率为3%。总的局部区域失败率为13%，仅局部区域作为首次失败的发生率为8%。这些结果与其他报道的系列相比具有优势，并为保乳手术后根治性放疗的经验积累贡献了大量患者。乳腺复发的相对低发生率可能与强调整合治疗的手术、病理和放射治疗方面，以及对有残留肿瘤高风险患者采取再次切除政策有关。
