乳癌手術後局部或區域淋巴結復發之放射線治療

Radiation Therapy for Local-Regionally Recurrent Breast Cancer

王重榮(Chong-Jong Wang) ； 林芳仁(Fang-Jen Lin) ； 陳明憲(Ming-Shen Chen) ； 梁雲(Wan Leung)

《中華放射線醫學雜誌》 13卷3期 (1988/09) Pp. 305-312

摘要

The present study retrospectively reviewed the result of 44 evaluable postsurgical breast ca. patients with recurrence at chest wall and/or regional lymphatics who received salvage treatment with radiation therapy at Chang-Gung Memorial Hospital between Feb. 1979 and Dec, 1984. 37 cases (84%) achieved initial complete response and 7 had persistent local disease at end of irradiation. 9 of 37 complete responders developed second recurrence during the follow up period from 4-31 months (median, 14 months). The difference of 5-year actuarial survival rate between 28(64%) local control and 16(36%) local failure patients (7 persistent local disease and 9 second recurrences) was statistically significant. (34% vs 19% p＜0.05) 18 patients (41%) developed distant metastasis 4-42 months (median, 17 months) after irradiation. Overall 5-year acturial survival rate and disease free survival rate were 32% and 20% respectively (median, 24 months). Prognostic factor analysis according to menstruation status, disease free interval, site of recurrence, number of recurrent site, size of recurrent tumor suggested that patients with disease free interval less than 18 months (25% vs 49%), multiple site of recurrence (16% vs 51%), recurrent tumor size greater than 3cm (24% vs 42%) carried significantly poorer risk of survival indicating that these patients, in addition to local irradiation, are justified for combined aggressive systemic treatment or trial of more active chemotherapy regimen.

關鍵字

乳癌復發 ； 放射線治療 ； 預後因素

並列摘要

The present study retrospectively reviewed the result of 44 evaluable postsurgical breast ca. patients with recurrence at chest wall and/or regional lymphatics who received salvage treatment with radiation therapy at Chang-Gung Memorial Hospital between Feb. 1979 and Dec, 1984. 37 cases (84%) achieved initial complete response and 7 had persistent local disease at end of irradiation. 9 of 37 complete responders developed second recurrence during the follow up period from 4-31 months (median, 14 months). The difference of 5-year actuarial survival rate between 28(64%) local control and 16(36%) local failure patients (7 persistent local disease and 9 second recurrences) was statistically significant. (34% vs 19% p＜0.05) 18 patients (41%) developed distant metastasis 4-42 months (median, 17 months) after irradiation. Overall 5-year acturial survival rate and disease free survival rate were 32% and 20% respectively (median, 24 months). Prognostic factor analysis according to menstruation status, disease free interval, site of recurrence, number of recurrent site, size of recurrent tumor suggested that patients with disease free interval less than 18 months (25% vs 49%), multiple site of recurrence (16% vs 51%), recurrent tumor size greater than 3cm (24% vs 42%) carried significantly poorer risk of survival indicating that these patients, in addition to local irradiation, are justified for combined aggressive systemic treatment or trial of more active chemotherapy regimen.

並列關鍵字

recurrent breast carcinoma ； radiation therapy ； prognostic factor