Chu F C, Lin F J, Kim J H, Huh S H, Garmatis C J
Cancer. 1976 Jun;37(6):2677-81. doi: 10.1002/1097-0142(197606)37:6<2677::aid-cncr2820370616>3.0.co;2-l.
Local and regional recurrences are frequent problems in breast cancer management. Radiation therapy is effective in producing long term remission. This study evaluates the results of radiation therapy of 215 patients with recurrent disease limited to the chest wall and/or regional lymph node areas. The local results showed complete control in 67% of cases (mean and median durations 32 months and 22 months, respectively), partial control in 24% of cases (mean and median 11 and 8 months, respectively) and no control in the remaining 9%. The radiation dose recommended for the treatment of recurrent mammary carcinoma is 5000 rads in 5 weeks for relatively small lesions. Supplementary local doses of 500-1000 rads in 1 week may be given to bulky lesions as necessary for residual disease. Although local relapse indicates a poor prognosis, it is by no means totally hopeless. Of 215 patients treated 44 (21%) survived 5 years and 10 (5%) survived 10 years following radiation therapy of recurrent disease. There were seven patients, or 3%, who were free of cancer at 5 to 15 years. Radiation therapy was valuable in controlling local lesions, and thus, in improving quality of survival, even in those patients who eventually died of metastatic disease.
局部和区域复发是乳腺癌治疗中常见的问题。放射治疗在实现长期缓解方面有效。本研究评估了215例复发疾病局限于胸壁和/或区域淋巴结区域患者的放射治疗结果。局部结果显示,67%的病例实现完全控制(平均和中位持续时间分别为32个月和22个月),24%的病例实现部分控制(平均和中位分别为11个月和8个月),其余9%未得到控制。对于相对较小的复发性乳腺癌病灶,推荐的放射剂量为5周内5000拉德。对于较大的病灶,如有残留疾病必要时,可在1周内给予500 - 1000拉德的补充局部剂量。虽然局部复发表明预后不良,但绝非完全无望。在接受治疗的215例患者中,44例(21%)在复发性疾病放射治疗后存活5年,10例(5%)存活10年。有7例患者,即3%,在5至15年时无癌。放射治疗在控制局部病灶方面具有价值,因此,即使在那些最终死于转移性疾病的患者中,也能提高生存质量。