早期乳腺癌保乳手术术后配合放疗与改良根治术的疗效对比

目的 对比分析早期乳腺癌保乳手术术后配合放疗与改良根治术的临床效果.方法 将本院2009年2月～2012年10月收治的180例Ⅰ期和Ⅱ期乳腺癌患者,根据患者手术方式不同分成改良根治术组125例和保乳手术组55例,保乳手术组11例术后行全乳适型调强放疗和瘤床加量放疗,改良根治术组有26例采取放疗.其他两组患者在手术后采取以CEF方案为主的化疗,而雌激素受体（ER）或孕激素受体（PR）阴性患者则采取内分泌治疗.结果 保乳手术组术后3年的生存率为90.9％,远处转移率为3.6％,局部复发率为5.4％;改良根治术组术后3年的生存率为95.2％,远处转移率和局部复发率分别为6.4％和4.8％,两组比较,差异无统计学意义（P＞0.05）.结论 保乳手术＋术后放射治疗早期乳腺癌的创伤小、痛苦少、恢复快,且可达到与改良根治术相同的效果,对于早期乳腺癌可推广应用.

Effect comparison between breast conservative surgery combining with postoperative radiotherapy and modified radical mastectomy on treating early-stage breast cancer

Objective To comparatively analyze the therapeutic effects of breast conservative surgery combining with postoperative radiotherapy and modified radical mastectomy on treating early-stage breast cancer.Methods 180 breast cancer patients at Ⅰ and Ⅱ stage admitted into our hospital from February 2009 to October 2012 were divided into modified radical mastectomy group （n=125） and breast conservative surgery group （n=55） based on patients＇ wishes.In the breast conservative surgery group,11 cases were adopted the conformal intensity modulated radiation therapy on the whole breast and high-dose radiotherapy on tumor bed.In modified radical mastectomy group,26 cases of patients ac- cepted radiotherapy.The CEF regimen as the main treatment in chemotherapy was selected for the other patients from both groups alter surgeries,but patients with negative ER or PR were applied with endocrinotherapy.Results The sur- vival rate 3 years after surgery,rate of distant metastasis,and local recurrence rate was 90.9%,3.6%,and 5.4% in the breast conservative surgery group,while in the modified radical mastectomy group,there was 95.2%,6.4%,and 4.8% respec- tively,there was no statistical difference betweent two groups （P〉0.05）.Conclusion In the treatment of early-stage breast cancer, the breast conservative surgery with postoperative radiotherapy at advantages of small wound,little suffering,and early recovery can obtain the same effect as modified radical mastectomy does,which is worthy of expansion in clinic.