早期乳腺癌保乳手术联合放射治疗的临床观察

目的观察早期乳腺癌保乳手术联合放射治疗的近期疗效、美容效果及副反应。方法42例早期乳腺癌行保乳手术，术后联合放射治疗，采用常规切线野照射46-50Gy／23—25次，后瘤床补量10—14Gy／5～7次。结果随访12～48个月，1年生存率100％，3年生存率97．62％，3年局部复发率4．76％。近期美容效果满意和一般占92．86％。2例局部复发，2例远处转移，2例出现3级放射性肺炎，3例Ⅲ度放射性皮肤反应，无Ⅲ-Ⅳ度骨髓抑制。结论早期乳腺癌行保乳手术联合放射治疗的近期生存率与乳腺癌根治术相同，近期美容效果满意，放射治疗的并发症可以接受。对符合条件的早期乳腺癌可推广此治疗方法。

Clinical observation of combination of breast-conserving surgery with postoperative radiotherapy for early stage of breast cancer

Objective To observe the short effect, cosmetic effect and toxicity of combination of breastconserving surgery with postoperative radiotherapy for early stage of breast cancer. Methods Forty-two patients with early stage of breast cancer received combination of breast-conserving surgery with postoperative radiotherapy, whole breast received 46 to 50 Gy in 23 to 25 fractions delivered by conventional tangent field and boost to tumor bed with 10 to 14 Gy in 5 to 7 fractions was given after whole breast irradiation. Results Followed up for 12 to 48 months, 1-year survival rate was 100% ,3-year survival rate was 97.62% ,3-year local recurrent rate was 4. 76%, recent satisfaction rate of cosmetic result was 92. 86%. Local recurrence was found in 2 patients,distant metastasis was found in 2 patients. Two patients appeared 3 grade of radiation-induced pneumonitis and three patients appeared 3 grade of radiation-induced dermatitis. Conclusion Recent survival rate and cosmetic result is satisfactory for the patients with early stage of breast cancer treated with combination of breast-conserving surgery and radiotherapy, the acute toxicity is acceptable.