Toonkel L M, Fix I, Jacobson L H, Bamberg N
Department of Radiation Oncology, Mount Sinai Medical Center, Miami Beach, FL.
Int J Radiat Oncol Biol Phys. 1988 Apr;14(4):677-81. doi: 10.1016/0360-3016(88)90089-2.
From 1974 through 1983, three hundred forty-three patients aged 70 years or older at diagnosis received comprehensive post-operative radiation therapy for localized (Stage I-III) breast cancer following surgical procedures ranging from incisional biopsies to classical radical mastectomy. The 5- and 10-year overall survival rates for this series of elderly patients are 67% and 33%. The respective disease-free survival rates are 67% and 42%. Over one-half of these women were treated by less than total mastectomy. No differences were seen in survival, disease-free survival, or local regional control rates comparing similarly staged patients treated by radical mastectomy, modified radical mastectomy, or tylectomy. Complications were few and seen primarily in those patients subjected to axillary dissection prior to irradiation. Long term survival appears to be achievable in the majority of elderly patients with regionally confined disease at presentation and aggressive treatment with curative intent is warranted. These elderly patients are often poor candidates for radical surgery. In this patient population, conservative surgery with post-operative radiation therapy is well tolerated and provides equivalent results to more radical surgical procedures.
从1974年到1983年，343例确诊时年龄在70岁及以上的患者，在接受了从切取活检到经典根治性乳房切除术等不同手术治疗后，接受了针对局部（I - III期）乳腺癌的综合术后放射治疗。这组老年患者的5年和10年总生存率分别为67%和33%。相应的无病生存率分别为67%和42%。这些女性中有超过一半接受的手术小于全乳切除术。在比较接受根治性乳房切除术、改良根治性乳房切除术或乳房肿瘤切除术治疗的同分期患者时，在生存率、无病生存率或局部区域控制率方面未发现差异。并发症较少，主要见于放疗前接受腋窝清扫术的患者。对于大多数初诊时疾病局限于局部区域且有治愈意向积极治疗的老年患者，似乎可以实现长期生存。这些老年患者往往不太适合进行根治性手术。在这一患者群体中，保守手术加术后放射治疗耐受性良好，且能提供与更根治性手术相同的效果。
