Local Recurrence After Postmastetomy Irradiation IN Breast Cancer

乳癌病人接受乳房術後放射線治療局部復發之探討

黃志仁(Chih-Jen Huang) ； 連熙隆(Shi-Long Lian) ； 候明鋒(Ming-Feng Hou) ； 湯人仰(Jen-Yang Tang) ； 黃旼儀(Ming-Yii Huang) ； 魏淑儀(Shu-Yi Wei) ； 何耀輝(Yu-Hui Ho)

《放射治療與腫瘤學》 7卷4期 (2000/12) Pp. 253-257

https://doi.org/10.6316/TRO/200007(4)253

摘要

目的：本研究主要目的在探討乳癌病患接受術後放射線治療其胸壁局部復發及再接受放射線治療的結果。
材料與方法：從1978年1月至1996年12月，共17位經病理切片證實為胸壁復發的乳癌病患接受局部放射線治療，我們使用4或6百萬伏特光子或9百萬伏特電子，每週治療五天，每天劑量為 2 Gy，總劑量為20 至 Gy ，平均劑量為48 Gy。
結果：結果顯示有14個病患（82%）發生遠處轉移，以肺轉移最常見，胸壁復發後存活期為3個月至3年6個月，平均存活期為15個月。胸壁復發多發生在術後照射後兩年內（佔90%），71%復發部位發生術後照射的範圍內。
結論：由放乳癌病患胸壁後發後有很高的遠處轉移率，而放射治療僅有局部控制的效果，因此針對遠處轉移的全身性治療必須更進一步的研究。

關鍵字

局部復發 ； 放射線治療 ； 乳癌

並列摘要

Purpose: The purpose of this study was to investigate the failure patterns of chest wall recurrence after postmastectomy radiotherapy (RT) in the patients with locally advanced breast cancer and the outcome of re-irradiaton.
Materials and Methods: From January 1978 to December 1996, 17 patients with pathology confirmed recurrent breast cancer were included in this study. The recurrent chest wall was treated with 4 or 6 MV photon through tangential field technique or 9 MeV electron beam through anterior or oblique portal, in a daily dose of 2 Gy, 5 days per week. Total dose ranged from 20 to 60 Gy with the average dose of 48 Gy.
Results: The median survival time from chest wall recurrence was 16 mouths, ranged from 3 months to 3.5 years. There was 90% of recurrence occurred within 2 years after postmastectomy irradiation, and 71% recurrent site occurred in the previous RT field. Fourteen patients (82%) developed distant metastases. Lung was the most common site.
Conclusion: Re-irradiation to the chest wall played only a palliative role. Further systemic management should be investigated and recommended due to high incidence of distant metastases.

並列關鍵字

Local recurrence ； Radiotherapy ； Breast cancer