Micheletti E, Plebani F
Radiol Med. 1986 Jan-Feb;72(1-2):43-8.
In the Radio Institute "O. Alberti" of Brescia from 1.1.73 to 31.12.79, 976 patients were treated with postoperative radiotherapy after radical mastectomy. The impact of therapy has been observed on the NED survival and evaluated for prognostic factors. The involvement of axillary lymph nodes appears to be the most relevant prognostic factor; the hormonal perimenopausal status was associated with a poorer prognosis both regarding the high frequency of axillary metastatic nodes and because in N+ 1-3 cases the probability of relapse is different and higher in comparison to post and premenopausal status. The site of origin of the primary tumor does not appear to be a significant prognostic factor related to the same number of nodes involved. Direct correspondence exists between diameter of the primary tumor and metastatic regional nodes. In N- patients the evaluated prognostic factors are not significant; in N+ patients the cases with a significantly different risk of relapse were identified for N+ 1-3 by the perimenopausal status and for N+ greater than or equal to 4 by the diameter of tumor. Postoperative radiotherapy alone seems to be able to modify the prognosis of operable breast cancer. The combination of local radiotherapy and adjuvant medical therapy could be a logical approach not only in order to improve the local control but also to prevent metastases.
1973年1月1日至1979年12月31日期间，在布雷西亚的“O. 阿尔贝蒂”放射研究所，976例患者在根治性乳房切除术后接受了术后放疗。观察了治疗对无疾病生存的影响，并对预后因素进行了评估。腋窝淋巴结受累似乎是最相关的预后因素；围绝经期激素状态与较差的预后相关，这不仅是因为腋窝转移性淋巴结的高频率，还因为在N + 1 - 3病例中，与绝经后和绝经前状态相比，复发概率不同且更高。原发肿瘤的起源部位似乎不是与相同数量受累淋巴结相关的显著预后因素。原发肿瘤直径与区域转移性淋巴结之间存在直接对应关系。在N-患者中，评估的预后因素不显著；在N+患者中，通过围绝经期状态确定了N + 1 - 3复发风险显著不同的病例，通过肿瘤直径确定了N+大于或等于4复发风险显著不同的病例。单独的术后放疗似乎能够改变可手术乳腺癌的预后。局部放疗和辅助药物治疗的联合可能是一种合理的方法，不仅为了改善局部控制，还为了预防转移。
