原发性乳腺癌患者隆胸或乳房重建后放射治疗的治疗结果

Treatment outcome with radiation therapy after breast augmentation or reconstruction in patients with primary breast carcinoma.

作者信息

Victor S J, Brown D M, Horwitz E M, Martinez A A, Kini V R, Pettinga J E, Shaheen K W, Benitez P, Chen P Y, Vicini F A

机构信息

Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.

出版信息

Cancer. 1998 Apr 1;82(7):1303-9.

PMID:9529022

Abstract

BACKGROUND

Analyses were performed to determine local control and cosmetic outcome of breast carcinoma patients with prosthetically augmented or reconstructed breasts who had received radiation therapy (RT).

METHODS

Twenty-one newly diagnosed breast carcinoma patients with prosthetically augmented or reconstructed breasts were treated with external beam RT. All patients received whole breast RT (median dose, 50.4 gray [Gy]) and 19 were boosted to a median dose of 60.4 Gy. A median dose of 50.4 Gy was delivered to the regional lymph nodes in 12 patients. Tissue equivalent bolus material was used in six patients. Seventeen patients received adjuvant systemic therapy. Cosmetic results were evaluated at 3-6-month intervals.

RESULTS

With a median follow-up of 32 months, good/excellent cosmetic results were observed in 71% of patients (100% in those with augmented breasts and 54% in those with reconstructed breasts). Four patients (19%) with fair/poor cosmetic outcomes required implant removal and/or revision. Multiple clinical and treatment-related factors were analyzed for their impact on cosmetic outcome. A worsened cosmetic result was observed with increasing stage (P = 0.076), breast reconstruction (vs. augmentation) (P = 0.030), and bolus application (P = 0.016). All patients with fair/poor cosmetic outcomes had time intervals from implant insertion to RT ranging from 53-213 days. Two patients developed an isolated local recurrence within the augmented breast.

CONCLUSIONS

Patients with prosthetically augmented breasts can undergo RT and expect good/excellent cosmetic results. Patients with reconstructed breasts are at a significantly greater risk for cosmetic failure. This risk may be related to the higher percentage of patients with advanced disease, those who received bolus application, and those who received earlier delivery of RT (after the cosmetic procedure) in reconstructed breasts.

摘要

背景

进行分析以确定接受放射治疗（RT）的乳房假体增大或重建的乳腺癌患者的局部控制情况和美容效果。

方法

21例新诊断的乳房假体增大或重建的乳腺癌患者接受了外照射放疗。所有患者均接受全乳放疗（中位剂量，50.4 格雷[Gy]），19例患者接受了中位剂量为60.4 Gy的瘤床加量照射。12例患者区域淋巴结接受的中位剂量为50.4 Gy。6例患者使用了组织等效填充物。17例患者接受了辅助全身治疗。每隔3至6个月评估美容效果。

结果

中位随访32个月，71%的患者观察到良好/极佳的美容效果（乳房增大患者中为100%，乳房重建患者中为54%）。4例（19%）美容效果一般/较差的患者需要取出植入物和/或进行修复。分析了多种临床和治疗相关因素对美容效果的影响。随着分期增加（P = 0.076）、乳房重建（与增大相比）（P = 0.030）和使用填充物（P = 0.016），美容效果变差。所有美容效果一般/较差的患者从植入假体到放疗的时间间隔为53至213天。2例患者在增大的乳房内出现孤立的局部复发。