Bolla M, Vrousos C, Husson B, Kolodie H, Vincent F, Bouchet Y, Couderc P
Sem Hop. 1980;56(29-32):1245-8.
178 cases of post-operative irradiation for breast cancer (145 T1, T2, T3 and 33 T4) are analyzed. According to the surgical procedure there are 146 cases of radical modified mastectomy (Patey) and 32 cases of radical mastectomy (Halsted). The axillary status reveals 50% of involved nodes, but radiotherapy has been systematic on chest wall and supra-clavicular, parasternal, axillary lymph nodes areas. Loco-regional failures are only situated on chest wall (3,9%) and in the supraclavicular area (1,7%). The five year actuarial rate of locoregional control is 93% and 98% if we exclude 7 locoregional failures contemporaneous or consecutive to a metastatic evolution. The five year actuarial rate of metastatic remission for patients with negative axillary nodes (N-) is 83% against 55% for N+ (p < 0,001). The five year actuarial survival rate is 92% (N-) and 64% (N+) (p < 0,001). We discuss about indications of selective irradiation of chest wall and parasternal area for patients with negative axillary nodes and also about post-operative immuno-suppression, and chronology of chemotherapy.
对178例乳腺癌术后放疗患者（145例T1、T2、T3期，33例T4期）进行了分析。根据手术方式，有146例改良根治性乳房切除术（帕蒂手术）和32例根治性乳房切除术（霍尔斯特德手术）。腋窝情况显示50%的淋巴结受累，但放疗已系统性地应用于胸壁、锁骨上、胸骨旁和腋窝淋巴结区域。局部区域复发仅位于胸壁（3.9%）和锁骨上区域（1.7%）。如果排除7例与转移进展同时或相继发生的局部区域复发，局部区域控制的5年精算率为93%和98%。腋窝淋巴结阴性（N-）患者的5年转移缓解精算率为83%，而腋窝淋巴结阳性（N+）患者为55%（p<0.001）。5年精算生存率在N-患者中为92%，在N+患者中为64%（p<0.001）。我们讨论了腋窝淋巴结阴性患者胸壁和胸骨旁区域选择性放疗的适应证，以及术后免疫抑制和化疗的时间安排。
