van Limbergen E, van den Bogaert W, van der Schueren E, Rijnders A
Radiother Oncol. 1987 Jan;8(1):1-9. doi: 10.1016/s0167-8140(87)80016-6.
From 1966 to 1979, 235 patients with operable breast cancer were treated by tumor excision and radiotherapy. The actuarial survival at 10 years was 94.8% for stage I and 58% for stage II tumors. Local recurrent cancer was seen in 23/235 patients and was related to T stage, N stage, width of surgical excision, radiation dose to the tumor bed and anatomopathological differentiation. Recurrences were seen in 1/7 of T0, 3/57 (5.2%) of T1, 11/102 (10.8%) of T2 and 2/6 of T3 tumors. Local control in the breast decreased significantly in N1b cases (p = 0.005) or when 3 or more axillary lymph nodes were positive (p = 0.0074). Local control after segmentectomy or tumorectomy was identical. However, a poorer local control was found in 20 cases treated with subtotal resection (p less than 0.05). A clear dose-local control relationship was found in this material, with a 100% local control in all T0, T1 tumors which received more than 1800 ret and all T2 tumors which received more than 2000 ret. As 19 of 23 breast recurrences were seen at the primary site in the breast we believe that booster doses should be given in order to maximise local control.
1966年至1979年期间，235例可手术乳腺癌患者接受了肿瘤切除及放射治疗。I期肿瘤10年精算生存率为94.8%，II期肿瘤为58%。235例患者中有23例出现局部复发性癌症，其与T分期、N分期、手术切除宽度、肿瘤床放射剂量及解剖病理分化有关。T0期肿瘤复发率为1/7，T1期为3/57（5.2%），T2期为11/102（10.8%），T3期为2/6。N1b病例（p = 0.005）或腋窝3个及以上淋巴结阳性时（p = 0.0074），乳房局部控制率显著降低。区段切除或肿瘤切除术后的局部控制情况相同。然而，20例接受次全切除治疗的患者局部控制较差（p < 0.05）。在该研究资料中发现了明确的剂量-局部控制关系，所有接受超过1800 ret的T0、T1期肿瘤及超过2000 ret的T2期肿瘤局部控制率均为100%。由于23例乳房复发中有19例发生在乳房原发病灶部位，我们认为应给予追加剂量以最大限度地提高局部控制率。
