Brufman G, Weshler Z, Prosnitz L R, Fuks Z
Isr J Med Sci. 1981 Sep-Oct;17(9-10):940-5.
Between 1960 and 1978, 85 patients with locally advanced T3-4N0-3M0 carcinoma of the breast were treated with 5,000 to 8,000 rad of external beam supervoltage radiotherapy. Initial clinical eradication of the tumor was observed in 76 of 87 cases (87%), but the actuarial probability of local control at 6 yr was only 53%. Furthermore, the actuarial probability of disease-free survival was 25% at 5 year and 13% at 10 yr. Most of the patients eventually succumbed to metastatic breast carcinoma and the actuarial survival at 5 yr was 43% and at 10 yr, 16%. The addition of adjuvant low-dose chemotherapy, given to 13 patients, did not affect the rates of local control, survival or disease-free survival. The most common long-term complication was extensive and deforming radiation-induced fibrosis of the treated breast. The actuarial probability of 10-yr survival without a local recurrence and without severe fibrosis of the treated breast was only 17.5%. The role of adjuvant high-dose chemotherapy in the treatment of locally advanced breast carcinoma and the possible use of improved radiotherapy techniques to achieve a more effective long-term local control and a more desirable cosmetic end result are discussed.
1960年至1978年间，85例局部晚期T3-4N0-3M0乳腺癌患者接受了5000至8000拉德的体外超高压放射治疗。87例患者中有76例（87%）最初观察到肿瘤临床消除，但6年时局部控制的精算概率仅为53%。此外，无病生存的精算概率在5年时为25%，在10年时为13%。大多数患者最终死于转移性乳腺癌，5年时的精算生存率为43%，10年时为16%。13例患者接受辅助低剂量化疗，这对局部控制率、生存率或无病生存率没有影响。最常见的长期并发症是治疗乳腺广泛且导致变形的放射性纤维化。10年无局部复发且治疗乳腺无严重纤维化的精算生存率仅为17.5%。讨论了辅助高剂量化疗在局部晚期乳腺癌治疗中的作用以及使用改进的放疗技术实现更有效的长期局部控制和更理想的美容效果的可能性。
