Outcome Of Radiotherapy For Primary Operable Invasive Breast Cancer AT A Medical Center

一醫學中心可手術之侵襲性乳癌的放射治療成果

陳海雯(Helen H.W. Chen) ； 張財旺(Tsai-Wang Chang) ； 蘇五洲(Wu-Chou Su) ； 郭浩然(How-Ran Guo) ； 曹朝榮(Chao-Jung Tsao) ； 梁永昌(Henry W.C. Leung)

《放射治療與腫瘤學》 7卷4期 (2000/12) Pp. 221-231

https://doi.org/10.6316/TRO/200007(4)221

摘要

目的：評估原發乳癌病人在一醫學中心公元1998年到2000年接受完整放射治療療程後的臨床治療成果。
材料與方法：自1988年到2000年間，在作者服務之醫學中心的放射腫瘤部共連續有341位可手術之侵襲性乳癌的病人接受完整療程之放射治療。對那些接受乳房切除術的病人，放射治療主要照射其前胸壁及其附近之淋巴結；其照射劑量的中數為50 Gy共計25之照射；對接受乳房保留手術的病的人，放射治療則另外追加15到20Gy 的劑量使其總劑量達到 65 - 70 Gy 。本研究由回顧病歷取得每位病人的相關資料，並比較臨床的治療成果。
結果：這341位病人的追蹤期間自7個月至13.1年不等，其中數為追蹤2.6年。其中142位病人接受乳房保留手術，199位病人接受乳房切除術；有264位病人(77%) 接受輔助性的化學治療。其五年的疾病局部控制率為90.5%，其五年的無疾病存活率為71.8%，其五年的全部存活率為81.4%。以疾病的分期來看，其五年的無疾病存活率和疾病局部控制率分別為：第一期95.5%和100%，第二A期93.2%和98%，第二B期62.4%和92.1%，第三A期58.8%和80.5%，第三B期43.7%和75.4%。全部共有24位病人(7.1%)在5個月到5.5年後發生局部復發(中數為1.6年)，但對142位接受乳房保留手術合併放射治療的病人，至今只有位有局部復發(中數為2.1年)。
結論：乳癌的放射治療為一非常有效的局部控制疾病的治療方法，我們的治療成果和其他醫學中心不相上下，對接受乳房保留手術合併放射治療的病人來說，我們目前有很低的局部復發率。

關鍵字

放射治療 ； 乳癌 ； 臨床治療成果

並列摘要

Purpose: To evaluate the treatment outcome of patients with primary operable invasive breast cancer who received radiotherapy at a medical center from 1998 to 2000.
Materials and Methods: We recruited 341 consecutive patients of primary operable invasive breast cancer who received radiotherapy in the department of radiation oncology of the authors’ medical center from 1998 to 2000. A median dose of 50 Gy in 25 fractions was delivered to the chest wall and/or regional lymph nodes of patients who had received mastectomy. For those who had received breast-conserving surgery, another tumor boost dose of 15 to 20 Gy (total dose: 65 to 70 Gy) was given. Information on each patient was collected by reviewing the medical records, and clinical outcome was compared.
Results: The median follow-up time for the 341 patients was 2.6 years (range, 7 months to 13.1 years). Among them, 142 received breast-conserving surgery and 199 received mastectomy. Systemic chemotherapy was used on 264 patients (77%) as a neoadjuvant of adjuvant treatment. The local-control rate at 5 years was 81.4%. The disease-free survival and local control at 5 years by stage were 95.5% and 100% for stage I, 93.2% and 98% for stage IIA, 62.4% and 92.1% for stage IIB, 58.8% and 80.5% for stage IIIA, and 43.7% and 75.4% for stage IIIB, respectively. A total of 24 patients (7.1%) had locoregional recurrence, which occurred at 5 months to 5.5 years (median, 1.6 years). But for the 142 BCS patients, only one of them developed local recurrence till now (median, 2.1 years).
Conclusion: Radiotherapy is a very effective adjuvant treatment on local control in breast cancer patients. Survival and local recurrence rates were comparable to other series. Our results also showed a very low rate of recurrence for patients receiving breast-conserving surgery followed by radiotherapy.

並列關鍵字

Radiotherapy ； Breast neoplasms ； Clinical Outcome