Pierquin B, Mueller W, Baillet F, Maylin C, Raynal M, Otmezguine Y
Bull Cancer. 1977;64(4):645-58.
Since 1961, we have treated 400 cases of breast cancers by radical radiotherapy (December 1976). The TNM classification of cases is: 25 per cent T1, 55 per cent T2, 20 per cent T3. 80 per cent of patients are N0 or N1a, 20 per cent are N1b. The therapeutic protocal is: for T1 lesions, lumpectomy plus radical radiotherapy, then boost dose with electrons to the axilla (24 Gy) and to the internal mammaryzone (15 Gy), and finally boost dose to the zone of the breast tumor by Iridium 192 implant therapy (25 Gy);--for T2 and T3 lesions, radiotherapy alone with a higher boost dose to the breast tumoral zone (37 Gy). The mammary tumor (or the tumoral zone) receives a total dose between 70 Gy (T1) and 90 Gy (T2 and T3). The five year results for 328 patients with at least one year follow up (actuarial calculations) yield a survival of 89 per cent T1, 84 per cent T2, and 66 per cent T3. The local recurrences are 8 per cent T1, 10 per cent T2, and 26 per cent T3; they can be rectified, under the condition of regular surveillance, by radical surgery. As to the cosmetic results, they are in one half of the cases quite good, in most others satisfactory, in a few poor. We add a prophylactic chemotherapy in the cases with high metastatic risk, i.e. T3 or N1b cases. This therapeutic protocol seems to be highly recommendable for T1 tumors, acceptable for T2, disputable for T3.
自1961年至1976年12月，我们采用根治性放疗治疗了400例乳腺癌患者。病例的TNM分类为：T1占25%，T2占55%，T3占20%。80%的患者为N0或N1a，20%为N1b。治疗方案为：对于T1病变，行肿块切除术加根治性放疗，然后用电子线对腋窝（24 Gy）和内乳区（15 Gy）进行追加剂量放疗，最后通过铱192植入疗法对乳腺肿瘤区进行追加剂量放疗（25 Gy）；对于T2和T3病变，单纯放疗，对乳腺肿瘤区进行更高剂量的追加放疗（37 Gy）。乳腺肿瘤（或肿瘤区）接受的总剂量在70 Gy（T1）至90 Gy（T2和T3）之间。对328例至少随访一年的患者（精算计算）的五年结果显示，T1患者的生存率为89%，T2为84%，T3为66%。局部复发率T1为8%，T2为10%，T3为26%；在定期监测的情况下，可通过根治性手术纠正。至于美容效果，一半的病例相当好，大多数其他病例令人满意，少数病例较差。对于有高转移风险的病例，即T3或N1b病例，我们加用预防性化疗。这种治疗方案对于T1肿瘤似乎非常值得推荐，对于T2可以接受，对于T3则存在争议。
