Baeza M R, Solé J, León A, Arraztoa J, Rodríguez R, Claure R, Cornejo S, Cornejo J
Instituto Radiomedicina IRAM, Santiago, Chile.
Int J Radiat Oncol Biol Phys. 1988 Apr;14(4):669-76. doi: 10.1016/0360-3016(88)90088-0.
At our Institution, the treatment policy for early carcinoma of the breast (T1-2, NO, AJC) is lumpectomy followed by radiotherapy to the breast and peripheral lymphatics. From October 1976 until December 1982, 171 patients have been admitted and treated. Radiotherapy was administered with 60 Co, 5.000 cGy in 5 weeks to the breast and lymphatics plus a boost to the scar giving q.s.p. 6.400 cGy at maximum tumor depth. With a minimum follow-up of 3 years and a median follow-up of 61.7 months the locoregional control was 94.2% and survival at 8 years with no evidence of disease (NED) was 77.2% with an overall survival rate of 90%. No difference in NED survival rate was found between Stage I and II. There was a tendency to better survival rate in those patients older than 50 years and also for post menopausal patients, however the difference did not reach statistical significance (66.7% NED survival at 8 years for premenopausal and 81.8% NED survival for post menopausal, also at 8 years, p = 0.056 Gehan). The time elapsed between surgery and radiation therapy (between 1 and 2 months) was found to be nonsignificant. Only 1 out of 171 patients had axillary dissection. The importance or lack of it, is discussed.
在我们机构,早期乳腺癌(T1 - 2,NO,AJC)的治疗策略是乳房肿瘤切除术,随后对乳房及周围淋巴管进行放射治疗。从1976年10月至1982年12月,共收治并治疗了171例患者。采用钴 - 60进行放射治疗,5周内给予乳房和淋巴管5000厘戈瑞,同时对手术瘢痕进行追加照射,在肿瘤最大深度处给予总量达6400厘戈瑞。最短随访3年,中位随访时间为61.7个月,局部区域控制率为94.2%,8年无疾病证据(NED)生存率为77.2%,总生存率为90%。I期和II期患者的NED生存率无差异。年龄大于50岁的患者以及绝经后患者的生存率有提高的趋势,但差异未达到统计学意义(绝经前患者8年NED生存率为66.7%,绝经后患者8年NED生存率为81.8%,p = 0.056,Gehan检验)。手术与放射治疗之间的时间间隔(1至2个月)无显著意义。171例患者中仅1例行腋窝淋巴结清扫术。文中讨论了腋窝淋巴结清扫术的重要性或其必要性的缺失。